Inspection on 15/10/07 for Hillview

This inspection was carried out on 15th October 2007.

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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Hillview 27/08/08

Hillview 23/01/07

Hillview 30/07/06

Hillview 15/11/05

Hillview 19/05/05

Hillview 07/12/04

Hillview 07/06/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Hillview 17 Collett Road Ware Hertfordshire SG12 7LY Lead Inspector Claire Farrier Key Unannounced Inspection 15th October 2007 10:15 X10015.doc Version 1.40 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 Hillview DS0000019430.V353112.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 Older People. 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. Hillview DS0000019430.V353112.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hillview Address 17 Collett Road Ware Hertfordshire SG12 7LY 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) 01920 469428 01920 469428 FP angelacsi@aol.com www.bmcare.co.uk Colley Care Limited (Trading as B & M Care) Care Home 36 Category(ies) of Old age, not falling within any other category registration, with number (36) of places Hillview DS0000019430.V353112.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd January 2007 Brief Description of the Service: Hillview is owned and operated by B&M Investments Limited, which is a private company. The home is registered to provide personal care and accommodation for up to 36 older people. Hillview is situated in a residential area of Ware, close to the town centre, with easy access to bus and rail services. It is a large house, which has been converted and equipped for use as a residential care home for older people. The accommodation is arranged over three floors and is, with one exception, in single rooms. Seven of the bedrooms have en-suite facilities. There is a passenger lift to all floors and the home is adapted for wheelchair use. There are gardens to the front and rear of the home, with car parking provided at the rear. A wooden decking area has been created at the front of the home, to provide an additional communal sitting area. The Statement of Purpose and Service Users Guide provide information about the home for referring social workers and prospective clients. The current charges range from £425 to £525 per week. Hillview DS0000019430.V353112.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. We spent one day at Hillview, and the people who live there and work there did not know that we were coming. The focus of the inspection was to assess all the key standards. Some additional standards were also assessed. An Expert by Experience (EBE) took part in the inspection. The EBE is a person who has experience of care services for older people. The EBE met and talked to most of the people who live in the home. We also talked to some of the staff, and to the home’s manager. The manager sent some information (the Annual Quality Assurance Assessment, or AQAA) about the home to CSCI before the inspection, and his assessment of what the service does in each area. Evidence from the AQAA has been included in this report. What the service does well: What has improved since the last inspection? There has been an increase in the number of care staff employed in the home since the last inspection. The home has also employed two part time activities co-ordinators, and everyone has a choice of a wide variety of activities in the home. The recording and administration of medication has improved. Hillview DS0000019430.V353112.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. Hillview DS0000019430.V353112.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hillview DS0000019430.V353112.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has sufficient information on residents’ needs and access to appropriate services to enable their needs to be met. EVIDENCE: 33 people have moved into the hone in the last year. At the last inspection we saw that a full assessment was completed before the resident was admitted to the home and where appropriate there was also an assessment from Social Services. Care plans are written from the information in the assessments, and the assessments and care plans provide appropriate information so that the staff can meet each person’s physical care needs. On this occasion we saw three care plans, which all included an assessment that was carried out before the person moved into the home. Hillview DS0000019430.V353112.R01.S.doc Version 5.2 Page 9 All the residents spoken to are happy in the home, and feel confident that the staff can meet their needs. One person had respite stays in two other homes before moving into Hillview, and she considers that Hillview is definitely better and cosier than the others. The staff have the experience and training to meet the assessed needs of the residents, and the care plans provide them with appropriate information. Any special needs are detailed in the care plans, for example diabetes and visual impairment. Hillview DS0000019430.V353112.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People in the home may be at risk because the information in the care plans is not recorded well, and the recording of medication is not accurate. EVIDENCE: The Annual Quality Assurance Assessment (AQAA) stated that the home has “Comprehensive, individual, person-centred care plans.” We looked at three care plans. They all contain information on the resident’s health and personal care needs. However the care plan for a person who has Parkinson’s disease had no information of the condition. The assessment provided by this person’s social worker before they moved into the home stated that medication must be given on time, as the person would suffer from tremors and stiffness if medication was missed. The care plan had no information or procedures for ensuring that these needs were met. The medication chart stated that medication should be given four times a day, but not at regular intervals. There is a moving and handling assessment for each resident, and appropriate Hillview DS0000019430.V353112.R01.S.doc Version 5.2 Page 11 risk assessments, including assessments for the risk of falls. However there was no risk assessment or management plan for a person who had left the home unnoticed on several occasions. One person’s assessment stated that they were prone to urinary tract infections, but there was no care plan to address this risk. We asked for a care plan for someone who uses a wheelchair. However the care plan had no mention of wheelchair use, and two moving and handling assessments that stated that two carers should assist this person to transfer were not written into the care plan. Everyone is weighed regularly, and their weights are recorded. However one person’s record showed a weight loss from August to September of 12.6kg, and no action was recorded to address the loss. It is possible that the weight was recorded wrongly, but the discrepancy had not been noticed and corrected. The Expert by Experience (EBE) spoke to most of the people who live in the home. He reported, “All the residents with whom I spoke indicated that they were satisfied with their accommodation and with the care they received.” The staff were observed to have a good relationship with the residents and to treat them with a friendly respect. They have time to talk to them and to provide the care they need without rushing. However one member of staff left a person in their wheelchair outside the toilet while she answered her mobile phone. The home has sound systems in place for the safe management of medication. However one medication that is given when required (PRN) was not properly recorded. The MAR (medication administration record) showed that 5 Loperimide for one person had been administered, but there were 9 missing from the box. Hillview DS0000019430.V353112.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is a range of activities to suit the needs of most of the people in the home. But a lack of transport means that community activities are limited. EVIDENCE: The Expert by Experience (EBE) reported, “The residents were complimentary about the attitude of staff and enjoyed the programme of activities on offer in the Home, but more than one commented that they would welcome more opportunity of going out (lack of transport being identified as a particular problem). They were however free to go out if they wished – one resident said she had recently enjoyed an outing with her family. Residents, and the family members I met, also said that relatives and friends could visit freely.” The home employs two part time activities co-ordinators, and everyone has a choice of a wide variety of activities in the home. On the day when we visited the home there was an arts and crafts activity, and several people enjoyed making Christmas cards. A quiz took place while they were making the cards. Other activities include flower arranging, hand massage, food tasting and card and board games. There is a structured exercise session once a week. Two Hillview DS0000019430.V353112.R01.S.doc Version 5.2 Page 13 people go to a local day centre once a week. Other outings take place when possible, such as lunch at the local pub. However the choice of outings is very limited due to the lack of transport. The home has no transport of its own, and there is no budget for providing transport so that people can go out and enjoy community activities. The activities organisers are very enthusiastic, and we noticed a big difference in the atmosphere in the home since the last inspection. However the activities organisers have had no training in providing activities for residential care, and they would benefit from this. The EBE joined the residents for lunch, where he reported that “the fare was plain and simple”. All the residents spoken to said that the food is very good. Hillview DS0000019430.V353112.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live in the home are confident that their concerns are listened to, and that they are safeguarded from the risks of abuse. EVIDENCE: The home has a satisfactory complaints procedure in place. The Expert by Experience (EBE) said that the people he spoke to confirmed that staff listened to them and heeded their wishes and preferences. There have been no complaints since the last inspection. The home has comprehensive procedures for prevention of abuse, and the staff spoken to were aware of their responsibilities for whistle blowing. Training in prevention of abuse was provided for the staff following the last inspection. In August 2007 a member of staff was dismissed for a theft that happened earlier in the year. The name has been placed on the POVA (Protection of Vulnerable Adults) register. Hillview DS0000019430.V353112.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained and provides a safe and comfortable environment for the people who live there. EVIDENCE: Hillview is a large house, which has been converted for use as a residential care home for older people. It is situated close the centre of the Ware. The decorations and furnishings in the home are domestic in style, and provide a homely and comfortable environment. There are gardens to the front and rear of the home, and a wooden decking area has been created at the front of the home, to provide an additional communal sitting area. The home appeared to be clean in all areas. The home has satisfactory procedures for handling and washing laundry in order to prevent the spread of infection. Hillview DS0000019430.V353112.R01.S.doc Version 5.2 Page 16 There is an efficient system for reporting any maintenance or repairs that are needed, and the records show that action is taken without delay. Water temperatures are recorded regularly, and they are monitored to ensure that they remain at a safe level. However the recording is not accurate, and some temperatures remain high (See Management and Administration). Hillview DS0000019430.V353112.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff numbers in the home are sufficient to ensure that all the residents’ needs are met. Staff receive the basic mandatory training, but there is no training available to enable them to meet the specific needs of individuals in the home. EVIDENCE: The Annual Quality Assurance Assessment (AQAA) stated that the home provides regular staff training, a full induction programme, the opportunity and encouragement to undertake NVQ qualifications, and correct staffing levels to meet residents needs. The numbers of staff in the home during the inspection were sufficient to meet the needs of the residents. There has been an increase in the number of care staff employed in the home since the last inspection. There were 32 residents in the home at the time of this inspection, and the staffing rota showed that there are 4 carers and one senior on duty in the mornings, 3 carers and one senior in the afternoons and 2 carers and one senior at night. Five staff have completed NVQ qualifications at level 2, and two are currently working towards level 3. The manager and the deputy manager are studying for the RMA (Registered Managers Award). A training matrix is maintained on Hillview DS0000019430.V353112.R01.S.doc Version 5.2 Page 18 the computer, which shows that there is a programme for all the staff to complete the mandatory health and safety training, and when updates are due. Training in dementia care is planned for January 2008, but there is no plan for training for other specific needs, such as Parkinson’s disease, diabetes, and depression. There is an induction training programme for new members of staff that meets the requirements of Skills for Care. We looked at two staff files. They contained all the required information to show that the home operates a thorough recruitment procedure. Hillview DS0000019430.V353112.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home does not maintain accurate records to monitor health and safety procedures, and ensure that there is no risk to the people living in the home. EVIDENCE: The registered manager left the home in March 2007. The deputy manager acted as manager until a new manager was appointed in August 2007. The new Manager has worked in a senior position, including manager, in two other homes for several years. He is currently studying for the RMA (Registered Managers Award). Hillview DS0000019430.V353112.R01.S.doc Version 5.2 Page 20 The Annual Quality Assurance Assessment (AQAA) stated that a new quality management system has been implemented in the home, and regular questionnaires are sent to residents and relatives. The quality management system includes audits of all the home’s policies and procedures on a rolling programme throughout the year. There are regular meetings for residents and their families, and questionnaires were sent out to them this year. Residents gave their views on the redecoration of the lounge. The Expert by Experience (EBE) said that the people he spoke to confirmed that staff listened to them and heeded their wishes and preferences. The arrangements for management of residents’ money were inspected at the last inspection and appeared to be accurate. Systems for managing the residents’ finances are transparent and backed up with signatures and invoices. Money is stored safely and adequate records are maintained in order to protect service users from financial abuse. The home maintains appropriate records for the health and safety of the residents and staff in the home, and staff follow the home’s policies and procedures. The hot water temperatures are monitored regularly. However the records show temperatures of 22.1°C to 30.8°C, which is very cool. It is possible that the temperatures are not measured correctly. This was noted at the last inspection, and no action has been taken to address the concerns. During a tour of the premises some water temperatures were tested. The water from the hot water tap of the bathroom on the top floor was very hot. When measured on the home’s mercury thermometer, the temperature was over 50°C. This may cause a risk of scalding to the people who live in the home. A professional Water Hygiene Risk Assessment was carried out on 18th June 2007. The water temperature was recorded as 50°C on that occasion. The report of the assessment states that temperature valves fitted on baths should be set at 44°C. No action has been taken to address this requirement. Hillview DS0000019430.V353112.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Hillview DS0000019430.V353112.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? YES 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 OP7 Regulation 15(1) Requirement The manager must ensure that all care plans provide adequate and appropriate details of each person’s needs, so that the staff have the information that they need to be able to meet their needs. Appropriate and adequate risk assessments must be put in place for all residents for situations in which there is any risk of harm or injury to themselves or others. Previous timescale of 31/03/07 not met Measures must be put in place to ensure that the weight of residents is recorded accurately. Appropriate actions must be taken following a recording of abnormal weight change, and the actions and results must be recorded in the care plan. Measures must be put in place to ensure that medication is audited effectively, and that any errors in medication are noted and rectified without delay. Timescale for action 29/02/08 2. OP7 13(4)(c) 29/02/08 3. OP8 12(1)(a) 29/02/08 4. OP9 13(2) 29/02/08 Hillview DS0000019430.V353112.R01.S.doc Version 5.2 Page 23 5. OP10 12(4)(a) 6. OP13 16(2)(m) 7. OP30 18(1)(c) (i) 13(4) 8. OP38 The registered person must ensure that the care staff understand the need to treat residents with respect at all times. Previous timescale of 31/03/07 not met Arrangements must be put in place so that the people in the home are able to take part in their choice of community activities outside of the home. Training must be made available for staff in specific conditions that may affect individual people in the home. Measures must be put in place to safeguard the residents from the risks of scalding. In particular: All hot water temperatures in bathrooms, toilets and bedrooms must be regulated to a safe temperature, close to 43ºC. All hot water temperatures in bathrooms, toilets and bedrooms must be regularly and effectively monitored and recorded. Previous timescale of 31/03/07 not met 29/02/08 29/02/08 29/02/08 15/10/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP12 Good Practice Recommendations The activities organisers would benefit from specific training in providing activities for residential care. Hillview DS0000019430.V353112.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hertfordshire Area Office CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 Hillview DS0000019430.V353112.R01.S.doc Version 5.2 Page 25 - 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. 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