Inspection on 13/07/05 for Hilltop House

This inspection was carried out on 13th July 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Hilltop House 02/12/08

Hilltop House 08/12/06

Hilltop House 17/01/06

Hilltop House 03/03/05

Hilltop House 15/09/04

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

CARE HOME ADULTS 18-65 HILLTOP HOUSE 30 Hilltop Road Twyford Berks RG10 9BN Lead Inspector Rhian Williams-Flew Unannounced 13 July 2005, 10:30 am 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. HILLTOP HOUSE H51-H01-S11393-Hilltop House-V222610-130705Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Hilltop House Address 30 Hilltop Road, Twyford, Berks, RG10 9BN 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) 0118 9340053 Mrs Janet Clarke Mrs Janet Clarke Care Home (CRH) 8 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia - over 65 years of age (MD(E) of places Mental disorder, excluding learning disabiliy or dementia (MD) HILLTOP HOUSE H51-H01-S11393-Hilltop House-V222610-130705Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 3 March 2005 Brief Description of the Service: Hilltop House is a care home for 8 people with mental health needs. It is registered for adults over 18 years of age and is able to accommodate both genders. It does not provide nursing care or provide care for people detained under the Mental Health Act 1983. The house is staffed throughout the 24hour period, with the night staff sleeping in. The house is owned and managed by Mrs Janet Clarke. The house is within a quiet residential area of Twyford. It is close to local shops and a bus stop is directly outside the property. Twyford has a train station, which is about 15 minutes walk from the house. HILLTOP HOUSE H51-H01-S11393-Hilltop House-V222610-130705Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection was conducted between 10.30 until 15.15 hours. The Registered Manager was present for the first two hours of the inspection. 7 of the 8 residents were at home and all were spoken with. 50 of the resident’s records were reviewed and a small number of the records for the running of the home. 3 members of staff were spoken with (1 member in private). What the service does well: What has improved since the last inspection? By the Registered Manager’s own admission, administration tasks are not one of her strength. She has therefore employed a person to assist with administrative tasks to ensure the smooth running of the home. HILLTOP HOUSE H51-H01-S11393-Hilltop House-V222610-130705Stage 4.doc Version 1.40 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. HILLTOP HOUSE H51-H01-S11393-Hilltop House-V222610-130705Stage 4.doc Version 1.40 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 HILLTOP HOUSE H51-H01-S11393-Hilltop House-V222610-130705Stage 4.doc Version 1.40 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, 3 & 5. This home has a clear admissions criteria to ensure that they meet the needs of the people who are admitted. Contracts of residency are also issued. EVIDENCE: The most recently admitted resident arrived in January 2005. It was clear that a full Care Programme Approach (CPA) meeting had been held prior to the persons admission to the home. The information contained was very detailed and clearly identified the persons needs. From subsequent reviews of this persons care it is clear that the home has been able to meet the assessed needs of the individual. This was verified in conversation with the person. Everyone who is resident in the home is issued with a contract clearly stating the terms and conditions of their residence in the home. HILLTOP HOUSE H51-H01-S11393-Hilltop House-V222610-130705Stage 4.doc Version 1.40 Page 9 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 & 9. The resident’s needs are identified clearly and all decisions concerning their well-being and everyday life are made with reference to these needs. The residents are encouraged and enabled to lead the lives they enjoy. EVIDENCE: 50 of the residents care plans were reviewed and it was noted that they had been drawn up in accordance with the resident’s reviews held under the Care Programme Approach. Care Programme Approach meetings are held approximately every three to six months. All the professionals concerned with the persons care are usually in attendance. It was clear from conversations with the residents and, in the review of their care plans, that they are encouraged and enabled to make decisions about their own lives. They are also encouraged to comment, contribute and participate in all aspects of the running of the home. Because of the needs of some residents the home has to implement various risk management strategies to ensure their safety. Care is taken not to be overly prescriptive and thus affect the persons freedoms and liberties. HILLTOP HOUSE H51-H01-S11393-Hilltop House-V222610-130705Stage 4.doc Version 1.40 Page 10 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, 14, 15, 16 & 17. This home is most certainly run to meet the residents needs. It is homely and has a relaxed atmosphere. Their rights are respected and the members of staff are more than willing to help them to have the lifestyles they wish. EVIDENCE: The home does provide the residents with the opportunity to relearn and reuse practical life skills. It also ensures that residents have an opportunity to fulfil their spiritual needs. A significant proportion of the residents attend a local resource centre where they engage in activities and therapeutic work. The home is situated in a residential area and the residents are very much part of the local community. They are able to visit the shops, leisure facilities places of worship, cafes and pubs and regularly do so. Access to transport is readily arranged for the residents if they are unable to use public transport. The staff team are incredibly flexible in order to provide escorts and company for the residents (if they wish) to attend leisure activities. Indeed, during the inspection a member of staff arrived to specifically take one resident to visit HILLTOP HOUSE H51-H01-S11393-Hilltop House-V222610-130705Stage 4.doc Version 1.40 Page 11 the shops as she had expressed a wish to do this. Comments from the residents supported this observation as they said that the members staff were very accommodating and helpful. The residents said that their relatives were welcomed on all occasions as were their friends. This year the residents had chosen not to have a fixed holiday time to a specific venue but were enjoying day trips to various places that they had said would be of interest to them. They had all enjoyed the visits to Bournemouth in Weymouth particularly, the fish and chip meals! The day following the inspection a number of them were visiting Portsmouth with their friends and colleagues from the resource centre. The daily routines and house rules to promote the resident’s independence, individual choice and freedoms are geared to the residents needs. Residents confirmed that the members of staff are respectful, approachable and always willing to help. From observations during the inspection it was clear to see that staff members have a good rapport with the residents and a very attentive to them. The home has a well maintained and a semi secluded garden which the residents enjoy sitting in. Indeed, on the day of the inspection one resident had decided to spend the day sunbathing. The members of staff were very attentive to ensure that he had sufficient sun protection cream and regular drinks. The menus for the previous few months were reviewed and were noted to be nutritious and wholesome. The residents confirmed that they participate in selecting the menus for the week. The hot midday meal was seen and the residents commented how much they enjoyed it. It is usual for staff members to prepare the food although the residents are encouraged to participate if they wish. Some said that they helped with vegetable preparations, laying tables and washing-up. HILLTOP HOUSE H51-H01-S11393-Hilltop House-V222610-130705Stage 4.doc Version 1.40 Page 12 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 & 19. This home does promote the physical and emotional health well-being of the residents. EVIDENCE: From the care plans seen and the comments made by the residents it was evident that support for their personal care is provided sensitively. Each of the residents has their own key worker. Evidence was seen to support the position that residents have regular access to their GP and, if required, the psychiatric services in the local community. HILLTOP HOUSE H51-H01-S11393-Hilltop House-V222610-130705Stage 4.doc Version 1.40 Page 13 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. This home does have a robust complaints procedure. EVIDENCE: There have been no complaints since the previous inspection. HILLTOP HOUSE H51-H01-S11393-Hilltop House-V222610-130705Stage 4.doc Version 1.40 Page 14 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) None. None of these standards were inspected on this occasion. EVIDENCE: None of these standards were inspected on this occasion. HILLTOP HOUSE H51-H01-S11393-Hilltop House-V222610-130705Stage 4.doc Version 1.40 Page 15 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) 32, 35 & 36. The home has sufficient numbers of staff and there is flexibility in the staff rota to ensure that members of staff are available when the resident’s needs are greatest. The Registered Manager needs to establish a regular system of supervision for the staff. EVIDENCE: This home employs sufficient staff to meet the needs of the residents. Over 50 of the staff have achieved NVQ 2 and above. This is a significant achievement for such a small home. The majority of the staff team has had the same personnel for a number of years. This is demonstrated in the continuity of care delivered to the residents. In conversations with staff it was clear that they knew the residents needs in considerable detail. This must be a significant benefit for the resident group. There is one member of staff who is aged 19 but the Registered Manager gave an assurance that she is never left in charge of the home. The training records of one member of staff were looked at in detail and it demonstrated that her training and development plan was in place and regular mandatory training as well as, specific interest training, had been provided. The supervision and appraisal records of staff were reviewed and deficits were found. The Registered Manager acknowledged these and she undertook to HILLTOP HOUSE H51-H01-S11393-Hilltop House-V222610-130705Stage 4.doc Version 1.40 Page 16 address the matter. It is her intention to draw up a yearly schedule for supervision to ensure it occurs on a regular basis. The standard is six sessions a year for every member of staff. HILLTOP HOUSE H51-H01-S11393-Hilltop House-V222610-130705Stage 4.doc Version 1.40 Page 17 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) 38 & 42. Fire doors should not be propped open when rooms are unattended. EVIDENCE: The Registered Manager has employed a person to provide administrative support. She commented that this is allowing her time to get all the homes systems and procedures up-to-date. Both the residents and members of staff spoken to confirmed that the manager is open to ideas and suggestions on how to improve the service for the residents who live in the home. Every member of care staff has an area of responsibility within the home. All said that the manager was very approachable and available. Standard 42 was not reviewed in its entirety however, it was noted that the fire doors (to rooms that were unoccupied) were being propped/wedged open. This should not occur. HILLTOP HOUSE H51-H01-S11393-Hilltop House-V222610-130705Stage 4.doc Version 1.40 Page 18 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 3 x 3 Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 x x 3 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 HILLTOP HOUSE Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x 3 x x x 2 x H51-H01-S11393-Hilltop House-V222610-130705Stage 4.doc Version 1.40 Page 19 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 36 Regulation 18(2) Requirement That all staff receive at least 6 supervision sessions each year. They should be recorded. A schedule for implementing regular supervision should be devised in the first instance. Fire doors in rooms that are not occupied should not be propped/wedged open. Timescale for action Schedule by 31.8.05. Evidence of sessions taking place by 31.10.05. Immediate and ongoing. 2. 42 23(4)(a) & (c) RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations HILLTOP HOUSE H51-H01-S11393-Hilltop House-V222610-130705Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection 2nd Floor, 1015 Arlington Business Park Theale Berks RG7 4SA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI HILLTOP HOUSE H51-H01-S11393-Hilltop House-V222610-130705Stage 4.doc Version 1.40 Page 21 - 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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