Inspection on 19/12/06 for Hilltop

This inspection was carried out on 19th December 2006.

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 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 30/01/06

Hilltop 08/07/05

Hilltop 31/01/05

Hilltop 30/07/04

Hilltop 27/10/03

Hilltop 16/06/03

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Hilltop Peewit Hill, West End Road Bursledon Hampshire SO31 8BP Lead Inspector Keith Hopkins Unannounced Inspection 19th December 2006 12:30 Hilltop DS0000012179.V318996.R01.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 DS0000012179.V318996.R01.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 DS0000012179.V318996.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hilltop Address Peewit Hill, West End Road Bursledon Hampshire SO31 8BP 023 8040 5944 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 Jane Strange Mrs Jane Strange Care Home 4 Category(ies) of Learning disability (4), Learning disability over registration, with number 65 years of age (4) of places Hilltop DS0000012179.V318996.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30/01/05 Brief Description of the Service: Hilltop is a family run home, registered to accommodate four adults with a learning disability. The home is situated on the outskirts of Southampton, with local shops nearby, and offers single, ground floor rooms, a communal lounge / dining room, large kitchen, conservatory and gardens. Bathroom and WC facilities are also on the ground floor. The registered provider and her family live on the premises, in first floor accommodation. Hilltop DS0000012179.V318996.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Five hours were spent visiting the home, during which time the opportunity was taken to look around the home, view records and policies and to talk to the manager and a carer. Three of the four service users were in the home with the fourth returning later in the day having been undertaking an external activity. The inspector was only able to communicate in a limited way with service users himself but did observe staff responding to expressed needs and interacting with service users in a professional yet friendly manner. Fees range from £750 to £1100 per week. What the service does well: What has improved since the last inspection? Staff have received additional training to enable them to better meet service users’ more specialist needs. Service users’ safety has been enhanced through the fitting of radiator covers, and privacy and dignity improved through the fitting of a lock to a toilet. Hilltop DS0000012179.V318996.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Hilltop DS0000012179.V318996.R01.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 DS0000012179.V318996.R01.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): 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has assessed the needs of its current service users well. These needs are clearly recorded and known to staff. EVIDENCE: Two service users’ files, including one relating to the most recently admitted service user were inspected and needs assessments seen within these. Files contained a good level of detail to enable staff to meet assessed needs. There was, for example, information regarding communication, emotional health and personal care. There was also information regarding medical needs together with details of more specific needs such as needing to see a community psychiatric nurse. Risk assessments about meeting care needs were also in evidence. The inspector also saw evidence that assessments were reviewed on a regular basis every six months or more often if necessary, with the placing authority involved in these every year. Hilltop DS0000012179.V318996.R01.S.doc Version 5.2 Page 9 The inspector also noted that the home had obtained a copy of the Social Services Care Management agreed plan where the Local Authority had been involved with service users. The manager and member of staff spoken with were clearly well aware of the contents of the assessments. Hilltop DS0000012179.V318996.R01.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 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a good care planning regime, which involves service users, and which addresses identified personal, social and health care needs. EVIDENCE: Two of the individual care plans, which had been developed from the initial assessments, were examined. These contained details of continuing personal and health care needs together with details of the support needed to meet such needs. Service users are supported in planning personal goals such as, for example, the development of skills to complete household tasks and to deal with personal hygiene. The inspector noted that records are kept on a daily basis detailing progress made towards meeting these goals, which are reviewed on a Hilltop DS0000012179.V318996.R01.S.doc Version 5.2 Page 11 regular basis. On the day of the inspection one service user had been attending a planned external activity. Service users were observed during the inspection to be supported in making decisions about day-to day activities, assisted by staff when this was necessary. Risk assessments are in place covering all areas of identified risk for service users. Hilltop DS0000012179.V318996.R01.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): 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users enjoy varied lifestyles and undertake activities of their choice, both internally and in the local community. Service users enjoy a varied and healthy diet. EVIDENCE: Hilltop DS0000012179.V318996.R01.S.doc Version 5.2 Page 13 Records examined by the inspector indicated that a full programme of activities and social opportunities was available for all service users, each of whom had an individually devised weekly activity plan. Activities were varied and included, for example, shopping, listening to music and helping in the garden. Various community facilities were accessed which included the cinema, pubs and local shops and cafes. A local market was visited weekly and service users were said to enjoy going to the occasional car boot sale. The home has a garden to the side and rear which is accessible to service users, and which also provides a small patio area. No service users currently attend church although the inspector was informed that this had happened in the past. There were no visiting relatives during the inspection although the manager reported continuing contact with service users families, who are welcome to visit at any time. The home’s menus were seen and were varied, the inspector being informed that individual and collective likes and dislikes were taken into account. It is understood that support is provided for service users to be involved in the preparation of meals. Snacks and drinks are available at all times, the inspector observing service users having these when they wished. Hilltop DS0000012179.V318996.R01.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 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a good level of personal support to service users ensuring that personal, health care and medication needs are met. EVIDENCE: Staff were observed to be supporting service users in undertaking day-to-day activities in a friendly and professional manner. All service users were appropriately dressed and tidily groomed and when staff needed to provide support in undertaking activities of a more personal nature this was done in private. The inspector was informed that there was good access to local GPs. Service users access local health care facilities such as the dentist and optician and Hilltop DS0000012179.V318996.R01.S.doc Version 5.2 Page 15 there was evidence of access to other health professionals such as a district nurse and the community psychiatric nurse. The home has a policy and procedure for staff to follow regarding the dispensing of medication. There is a monitored dosage system in place and the inspector checked medication for two service users against medication administration records, which were accurate and up-to-date. Medication was securely stored in a locked cupboard in the office. Staff responsible for dealing with medication have been trained to do so. Hilltop DS0000012179.V318996.R01.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): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are well protected through procedures for dealing with complaints and suspected abuse, which are known to staff. EVIDENCE: The home has a complaints policy and procedure, a copy of which is included within the service user guide, which each service user has. It was reported by the manager that the home had had no complaints to deal with in the previous 12 months, and that service users had access to a local advocacy scheme. The home also has a policy and procedure relating to adult protection, with information produced by Hampshire Social Services being available for staff to consult. Staff have been trained in this and when interviewed the carer confirmed her understanding of what to do in the case of suspected abuse. Hilltop DS0000012179.V318996.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a safe and comfortable environment, which is suitably furnished, adequately maintained and meets service users’ needs. EVIDENCE: The tour of the building showed this to be clean and tidy throughout and there were no undue odours. Communal areas were acceptably furnished and decorated and gave the building a very ‘homely’ and domestic feel. There are adequate bathroom and toilet facilities. Since the most recent inspection, following a risk assessment, some of the home’s radiators have been covered to prevent the possibility of scalding. Hilltop DS0000012179.V318996.R01.S.doc Version 5.2 Page 18 Three bedrooms, which were all adequate in size, were inspected and had clearly been personalised, to considerable degrees. Service users were observed to be freely making use of communal areas, such as the lounge and kitchen, in addition to their bedrooms. The home’s laundry arrangements are domestic in nature, which suits the size of the home. There is a procedure for dealing with any soiled linen, although the inspector was informed that this was an infrequent occurrence. Various maintenance certificates were seen and were in order and up-to-date, the manager confirming that minor building items requiring attention were recorded in the maintenance book. During the inspection the inspector observed a maintenance person dealing with such items. The home has a Health and Safety policy and the manager and member of staff spoken with were clearly aware of Health and Safety issues. Hilltop DS0000012179.V318996.R01.S.doc Version 5.2 Page 19 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): 32, 33, 34 and 35. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are supported by a well-trained staff team. The inspector was unable however to access an up to date staff roster so the home was not able to evidence that there were sufficient staff on duty at all times to meet service users’ needs. EVIDENCE: The inspector examined two staff files, which contained evidence of Criminal Records Bureau checks having been carried out, together with evidence of a sound and comprehensive induction training programme. Application forms and references were also in evidence. The inspector was able to examine the training records of both of these staff. These confirmed details of courses undertaken. Courses included Challenging Behaviour, Moving and Handling, First Aid, Protection of Vulnerable Adults, and Dementia Training. The carer interviewed confirmed that opportunities to undertake training were good. Hilltop DS0000012179.V318996.R01.S.doc Version 5.2 Page 20 During the inspection the inspector observed the staff member interacting with and supporting service users in a friendly yet professional manner. No staff rosters later than one ending on 17th September 2006 were available, the manager explaining that the small group of staff worked ‘more or less’ the same hours each week. The home must have a duty roster of persons working and a record of whether the roster was actually worked so that a judgement may be made as to whether there are sufficient persons to meet service users’ needs. Hilltop DS0000012179.V318996.R01.S.doc Version 5.2 Page 21 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, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is in the main well run by an owner/manager who expects to become qualified shortly. Service users do however need to be better protected through the keeping up to date of records required by regulation. EVIDENCE: The registered manager has had several years experience of running the home and is expecting to complete the Registered Managers Award shortly. The inspector was informed that service users were consulted through a regular monthly meeting and have the ability to comment on the services on Hilltop DS0000012179.V318996.R01.S.doc Version 5.2 Page 22 an on-going basis, although there was no evidence of this later than December 2005. The manager explained that quality questionnaires, one for service users and one for visiting professionals were to be introduced at some point in the future, and the inspector saw copies of these. The home has a policy for the control of substances hazardous to health known to staff. Chemicals and other items were securely stored in locked cupboards and the manager and staff member were aware of health and safety issues. The home has a health and safety policy known to staff. The inspector did not observe any immediate hazards to the health and safety of service users during the tour of the building. A sample of policies, procedures and records required by regulation were inspected and were, in the main, in order and up to date. The inspector pointed out to the manager however that the home’s fire book was not up to date. Hilltop DS0000012179.V318996.R01.S.doc Version 5.2 Page 23 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X X 2 Hilltop DS0000012179.V318996.R01.S.doc Version 5.2 Page 24 No 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 YA33 Regulation Schedule 4 (7) Requirement A duty roster must be maintained to identify the persons working at the home, and a record kept of changes to this roster. The registered person must demonstrate that service users and their representatives are consulted regarding the quality of the service provided. The home’s fire book must be kept up-to-date. Timescale for action 31/01/07 2. YA39 24 (1) 31/03/07 3. YA42 Schedule 4 (14) 31/01/07 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 Standard Good Practice Recommendations Hilltop DS0000012179.V318996.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 DS0000012179.V318996.R01.S.doc Version 5.2 Page 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. 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