Inspection on 17/10/06 for Hilltop

This inspection was carried out on 17th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hilltop 29/10/07

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

CARE HOME ADULTS 18-65 Hilltop Hilltop 32 Trewartha Park Weston Super Mare North Somerset BS23 2RT Lead Inspector Catherine Hill Unannounced Inspection 17th October 2006 10:00 Hilltop DS0000067863.V316346.R02.S.doc Version 5.2 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 Hilltop DS0000067863.V316346.R02.S.doc Version 5.2 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 Adults 18-65. 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. Hilltop DS0000067863.V316346.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hilltop Address Hilltop 32 Trewartha Park Weston Super Mare North Somerset BS23 2RT 01934 644875 01934 613517 enquiries@homes-caring-for-autism.co.UK www.homes-caring-for-autism.co.uk Homes Caring for Autism Limited 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) Mrs Georgia Ford Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Hilltop DS0000067863.V316346.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. May provide a service for up to eight younger adults in the age range 16 - 18 years May provide a service for up to eight younger adults in the age range 18 - 40 years. People over the age of 45 may be admitted with the express consent of CSCI. Date of last inspection Brief Description of the Service: Hilltop was originally registered as a home for older people but changed ownership several months ago and has re-opened as a home for up to 8 younger people with autism, aged between 16 and 40. Prior to opening, the new owners made extensive alterations to the premises to improve the quality of provision and ensure that it is more suited to the needs of the new resident group. The service is aimed at people whose behaviour can be challenging, and a high level of intensive one-to-one work is offered. The aim is to enable people to learn new ways of managing their own behaviour in order to live more independently or otherwise improve their quality of life. The home is in a quiet residential area, within easy reach of the town, the seafront, and other local amenities. Hilltop DS0000067863.V316346.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out over one day by two inspectors, within three months of the new owners taking over the home. The first couple of months of their ownership were largely spent in carrying out extensive alterations to the premises, and only two residents had moved in by the time of this inspection. The inspectors briefly met each of these people, and spent a long time talking with staff individually and looking at the recording and care management systems the home is in the process of setting up. Following this inspection, the lead inspector contacted the Social Worker for one of the residents to get their feedback. Inspectors looked at the following documentation: • pre-admission assessments and transition plans • care plans • residents individual timetables of activities • medication records • menu records • abuse and whistleblowing procedures • staff recruitment records • employees handbook • the staff rota • records of residents cash held by the home for safekeeping • policies and procedures manual Inspectors also did a tour of the premises. What the service does well: A very clear and well-defined system has been set up for planning, delivering, and recording the service given to residents. This helps to ensure that residents get a high quality and consistent service, and that staff feel confident and well supported. Staff have an unusual level of experience and qualifications, and this was reflected in the professionalism with which they did their jobs. Interactions with residents were positive and skilled, and care records showed that staff have a real insight into residents points of view. This will help residents to feel safe and respected, and to learn acceptable ways of managing their behaviour. Hilltop DS0000067863.V316346.R02.S.doc Version 5.2 Page 6 The environment is very well-suited to residents needs and preferences. Wherever practicable, adaptations are being made to meet individual requirements. What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Hilltop DS0000067863.V316346.R02.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Hilltop DS0000067863.V316346.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5 Quality in this outcome area is excellent. Pre-admission information and procedures are very thorough, enabling both the home and the prospective resident to be reasonably sure that the placement will be suitable. Some minor changes to the records will improve practice still further. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A detailed and informative Statement of Purpose was submitted to CSCI as part of the providers application to be registered. The pre-admission assessment carried out on residents before they have a trial period in the home is designed to gather in-depth information. Very specific transition plans were drawn up for each resident, in conjunction with their families and Social Workers, to ensure that the move was made as smooth as possible for them. Social Workers and other external professionals had contributed detailed assessments and initial care plans. Some information evidently written by staff at Hilltop had not been dated. It is important for staff to get into the habit of signing and dating all documentation. Hilltop DS0000067863.V316346.R02.S.doc Version 5.2 Page 9 Pre-admission visits were planned on an individual basis. One person visited the home many times before making the decision to move in, and staff from the home visited residents in their previous placements on several occasions. This helped to ensure that the placement was likely to be suitable, but also helped to build relationships so that the person could settle in more quickly once they moved in. The residents contract is in the form of a service users agreement. This is in Widget symbols to make it more understandable to residents, but the name of another of the provider’s homes is at the top of the document. This needs to be updated to show that the agreement relates to Hilltop. Fees are negotiated on an individual basis. Hilltop DS0000067863.V316346.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9, 10 Quality in this outcome area is good. Residents needs are being thoroughly documented and well met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents care plans included detailed information on areas of particular concern. Personal care is recorded on a checklist that staff sign and add any comments to. Daily reports summarise the days events, including how the persons mood and behaviour have been, and what activities they did. Meals and drinks offered to each person throughout the day are also recorded. Each person had a pen picture on their file, but these need to be updated because some were drawn up a while ago at previous placements. Detailed descriptions of the way each person likes their personal care needs to be met, Hilltop DS0000067863.V316346.R02.S.doc Version 5.2 Page 11 and of other preferred routines, have been written up. As staff get to know residents better, this information will become even more detailed and useful. Risk assessments have been drawn up for each resident. These identify the areas of risk and how they can be reduced in ways that do not unnecessarily curb the persons freedom. Residents care records are kept securely, and staff took care to discuss sensitive issues discreetly. Hilltop DS0000067863.V316346.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16, 17 Quality in this outcome area is good. Residents get good opportunities to pursue an individual and fulfilling lifestyle. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Individual timetables have been set up, based on what families and professional carers have been able to tell the staff about residents interests. The two residents each have a full and varied timetable. Activities are structured enough to provide a predictable and comfortable schedule for each person, but they are flexible enough to account for changing needs and Hilltop DS0000067863.V316346.R02.S.doc Version 5.2 Page 13 priorities. Staff are compiling photo albums of activities for each resident to enable the person to take more part in planning their own timetables. Widget symbols are being used with one resident to explain where he will be going and why. While each person has a fairly full schedule of planned activities, staff are very flexible in the way they carry this out. For example, one resident had a disrupted night just before this inspection and did not have the energy to carry out the planned activity, so staff offered him a range of low-key alternatives instead. The type of activities being offered to the residents are likely to suit their interests and abilities. Residents get one-to-one support at present, and staff create plenty of opportunities for each person to spend time in the local community. According to their individual interests, residents have been able to spend time at local pubs, at the cinema, at a car boot sale, playing on the machines in an arcade, and shopping in town. Residents are also being supported to take on as much responsibility as possible for their own independent living, and staff work alongside them on daily household tasks to help them build their skills. The computer in the activities room now has Internet access. Some of the artwork produced by residents is being displayed in this room. Staff have started work with one resident on creating photo diaries, which he carries with him so that he can tell the various people in his life what he has been up to. The team is coming up with some creative ways of enabling residents to have a say in the way the home is run. Photos of the staff who are going to be on duty for each shift during the day are posted on the residents noticeboard. The interactions that inspectors witnessed between staff and residents were really positive, with staff encouraging and reinforcing appropriate behaviour, and dealing with inappropriate behaviour calmly and in line with the agreed strategies. Despite having to deal with some quite challenging behaviour, the staff involved kept responding to the person on an adult-to-adult basis. The staff member with delegated responsibility for menu planning has a degree in nutrition. Residents have been asked about their food preferences, and have been closely involved in menu planning. Each persons food intake is being carefully recorded to ensure that menus are meeting their needs. The detail of this record also helps staff to monitor if particular types of food are having any effect on behaviour. Menus included plenty of choice and were balanced and varied. The foods in the kitchen were of good quality and included a variety of healthy snacks. Hilltop DS0000067863.V316346.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. Residents health care needs are being carefully documented and links are being built with external health care professionals to ensure these needs are well met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents have been registered with a local GP but staff are still in the process of trying to find dentists and opticians. Health Action Plans are not yet in place, although care plans broadly address health care needs and to give more in-depth guidance on residents specific health issues. The inspector gave the contact details of the local authoritys Action for Health Coordinator to the staff member with delegated responsibility for this area, so that she can be Hilltop DS0000067863.V316346.R02.S.doc Version 5.2 Page 15 approached to offer the team some guidance about drawing up Health Action Plans. The design of the medicine cabinet conforms to the relevant guidance. A packet of Paracetamol was inside, which appeared to be used as a homely remedy. Administration of these tablets had been recorded, but the balance on the record did not tally with the actual amount of tablets left. Staff had written the date when a bottle of eyedrops had been started, in line with the good practice guidance. The MARS (Medication Administration Record Sheet) record had been handwritten as an interim measure. The home is in the process of setting up an arrangement with the local pharmacist, who will print these records. The inspector reminded staff that, where they need to hand-write entries on these records, two staff must sign them. These records were in good order, with very few unexplained gaps. MARS are at present kept in each residents file. This is manageable at present, but is likely to create a major task for staff who give out medicines after more residents are admitted, so the inspectors suggested that the home considers keeping these records together in one folder. The inspector recommended that a photograph of the resident is kept on their MARS record, as an additional means of checking that the right medication is being given to the right person. Staff had already considered this and were waiting for use of a digital camera. Hilltop DS0000067863.V316346.R02.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. There is an open culture which ensures concerns can be aired and addressed, but the written abuse procedures are not clear enough. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a wealth of guidance available to staff about abuse, but some of this is contradictory and some does not tally with North Somerset Social Services No Secrets guidance. One policy advised staff to approach the Registered Care Home Providers Association if they felt that they could not take any concerns to the home’s manager. It would be more appropriate for staff to take their concerns to the local Social Services authority in the first instance, and to CSCI. Another policy said that the alleged abuser is to be interviewed but does not explain who is responsible for this nor emphasize that this sort of investigation should only be done by the home after the Police or Social Services Department have agreed it. Only the whistleblowing policy mentions CSCI and gives its contact details, but this does not make it clear that staff have a duty to report any concerns. In fact, it erroneously states that employees must not disclose any concerns other than to the home’s manager Hilltop DS0000067863.V316346.R02.S.doc Version 5.2 Page 17 and the provider’s head office. All abuse guidance needs to be reviewed to ensure it complies with No Secrets and is consistent. In other respects, this guidance was very useful: it gave clear and pertinent examples of what might constitute abuse, and the advice given was generally straightforward. The acting manager has some basic knowledge of the separate legislation affecting residents within the 16-18 years age group, and intends getting a copy of the Children Act for reference. Night-time arrangements have been set up to ensure that people under the age of 18 are properly protected. Staff described an open culture in which any concerns can be aired and are addressed positively by the management team. Staff felt encouraged to raise concerns and to make constructive criticism. Hilltop DS0000067863.V316346.R02.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29, 30 Quality in this outcome area is excellent. Residents benefit from a particularly pleasant and comfortable environment that is well suited to their needs and lifestyles. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The premises were extensively remodelled when the new owner took over. Areas that could have been flashpoints, increasing the likelihood of confrontation between service users, have been redesigned. Corridors have been widened and straightened to allow people to pass with more space on either side. Some bedrooms are protected from the main corridor by small foyers. The entire home has been redecorated, and the kitchen and laundry have been completely redesigned and refurbished. New hot water and central heating systems have been installed, with inbuilt temperature regulation for residents safety. All windows have been fitted with suitable restrictors. Hilltop DS0000067863.V316346.R02.S.doc Version 5.2 Page 19 All bedrooms are single and 4 have their own ensuite bathroom. The other 4 bedrooms share 2 bathrooms, 1 bathroom being allocated to the sole use of the occupants of each pair of bedrooms. Each bedroom is lockable, and staff carry a master key so that they can get quick access in an emergency. The bedrooms have been painted in a neutral colour until their prospective occupant chooses their own colour scheme. Residents have also been able to choose their own carpets and furnishings. One resident has very particular requirements from their own room, and Homes Caring for Autism Limited have carried out a number of modifications to accommodate this and help the person feel as comfortable as possible. There is a good range of communal rooms so that residents can have quiet time or one-to-one time with staff, and can enjoy a variety of activities at home. Communal rooms have been equipped with attractive, modern furniture that is likely to suit the residents needs. There is a large lounge with a small conservatory area leading off it. The conservatory can be used for dining if someone prefers not to use the larger dining room. There is also an activities room and a relaxation room downstairs. Residents can use the large front garden independently and safely. The back garden is at present very overgrown and not suitable for residents use, but it is planned to carry out improvements within the next year. The laundry room has two washing machines and two tumble dryers, which residents can use with staff support. One resident is particularly anxious that laundry is returned promptly, so the home is acquiring an industrial tumble drier to speed up the process. Hilltop DS0000067863.V316346.R02.S.doc Version 5.2 Page 20 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36 Quality in this outcome area is good. The staffing practices that are being developed are likely to promote residents safety and well-being. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The deputy manager was in charge at the beginning of this inspection, and the acting manager came on duty later in the day. Two support workers were on duty, working one-to-one with the two residents. The Administrator was also working. At present, there are three staff on duty in the mornings, and two in the afternoons. Staff are widely experienced and highly qualified. Attractive pay scales help to ensure that high-calibre staff can be employed and retained. A really good range of training courses has already been laid on, and there is a full schedule of future training planned. All staff recently had Basic Food Hygiene training and PECs (Pictorial Exchange Communication) training. Training planned for the near future includes Makaton (a system of hand signs Hilltop DS0000067863.V316346.R02.S.doc Version 5.2 Page 21 used for communication) and abuse awareness. A professional trainer who herself has autism has done some training for staff and is getting involved in helping staff to draw up effective reactive strategies with the residents. NVQ training is in the process of being arranged. Thorough records are kept of staff recruitment. The files sampled showed that all the necessary pre-employment checks are being satisfactorily completed before staff work with residents. Staff were required to read and sign the employee handbook and the policies when they started work, and are undergoing thorough induction training. Hilltop DS0000067863.V316346.R02.S.doc Version 5.2 Page 22 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 41, 42, 43 Quality in this outcome area is good. Residents and staff benefit from a clear and accountable management structure, and the home is being well run. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has left but her deputy is acting as manager and intends submitting an application to be registered within the next few weeks. In the interim, her line manager is in the home on an almost daily basis to give Hilltop DS0000067863.V316346.R02.S.doc Version 5.2 Page 23 support, and is also working some hands-on shifts to demonstrate to the team how the written strategies for each resident can be put into practice. The line manager is himself experienced and qualified in working with this client group. The staff on duty during this inspection were really positive about working at the home, and described a very open culture in which they are encouraged to question practice and contribute their ideas. Highly effective support systems have been set up, and staff felt these are working very well. Each staff member will be having formal supervision with the acting manager every two months, but staff felt that all members of the management team are readily accessible whenever support is needed. The interactions between staff and residents were positive and respectful, regardless of residents behaviour. During this inspection, staff had to deal with a difficult situation, and handled this calmly and in a way that allowed the person to modify their behaviour without losing face. At present, resident consultation is very informal but the acting manager plans to set up a more structured system as more residents were admitted. The actual methods for consulting each person will be tailored to their individual needs - for example, a picture-and-symbol questionnaire might be used with one person, but one-to-one conversation might be used with another. A good framework for administrative systems is in place, and is gradually being padded out as records are created. The policies and procedures file contained some straightforward and effective guidance to staff, and this emphasized that residents well-being must be at the heart of all the staff do. However, care needs to be taken to ensure that each piece of guidance is consistent with the other policies in place. (See section above on abuse policies.) Inspectors suggested that the challenging behaviour policy would benefit from giving slightly more detailed guidance. This policy is linked to the home’s restrictive physical intervention policy, which emphasizes using defusing techniques in preference to physical restraint, and which is cross-referenced to individual residents behaviour care plans. It also gives guidance on recording incidents where restraint was used, on monitoring and reviewing conflict situations, and on whistleblowing. Incident reports gave informative descriptions of what had happened and of any obvious precursors. They also explored possible reasons for the incident and potential ways of avoiding a recurrence. Accident records were similarly detailed. Hazardous chemicals were being used and stored safely. Residents are encouraged to retain as much responsibility for their own finances as they are individually able. Two staff sign the record where the resident is unable to sign for themselves. The system currently in use is potentially confusing, because staff need to access both the home’s petty cash Hilltop DS0000067863.V316346.R02.S.doc Version 5.2 Page 24 tin and the residents personal money tin. There were some unsigned and undated notes in the petty cash tin, indicating that a resident owed small amounts to this fund. However, these notes didnt appear to have any bearing on the current balance in the tins or on the record. To further complicate this system, a resident has two cash tins: one marked activity and the other marked personal care. When the inspector checked the receipts against the entries on the cash records, the amounts did not tally. The last entry on one residents cash record showed an amount signed out but there was no receipt to support this expenditure. The administrator intends changing the system to avoid the potential for the home’s and the residents monies to become muddled up. Inspectors recommended that these accounts are audited regularly so that any errors can be quickly spotted and put right. Hilltop DS0000067863.V316346.R02.S.doc Version 5.2 Page 25 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 Standard No Score 1 4 2 4 3 4 4 4 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 4 25 4 26 3 27 3 28 4 29 3 30 3 STAFFING Standard No Score 31 3 32 4 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 3 3 3 2 3 3 Hilltop DS0000067863.V316346.R02.S.doc Version 5.2 Page 26 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. 2. Standard YA20 YA23 Regulation 17 13 Requirement Timescale for action 17/10/06 3. YA41 17(Sch.4) Accurate records of any home remedies administered to residents must be maintained. The home’s abuse guidance must 24/10/06 be reviewed to ensure it complies with No Secrets and is consistent. A clear and accurate record must 24/10/06 be kept of all money or other valuables held for safekeeping on service users behalf. 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. 2. Refer to Standard YA20 YA41 Good Practice Recommendations A photograph of the resident should be kept on their MARS record as an additional means of checking that the right medication is being given to the right person. The accounts of service users cash held by the home for safekeeping should be regularly audited so that any errors can be quickly put right. Hilltop DS0000067863.V316346.R02.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Hilltop DS0000067863.V316346.R02.S.doc Version 5.2 Page 28 - 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!