Inspection on 19/05/05 for Hillview

This inspection was carried out on 19th May 2005.

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

The inspector 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 15/10/07

Hillview 23/01/07

Hillview 30/07/06

Hillview 15/11/05

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 Jeffrey Orange Unannounced 19 May 2005 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 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 I52 s19430 Hillview v228225 190505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Hillview Address 17 Collett Road, Ware, Herts, SG12 7LY 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) 01920 469428 01920 469428 Colley Care Limited Mrs Angela Page CRH Care Home 36 Category(ies) of OP-36 registration, with number of places Hillview I52 s19430 Hillview v228225 190505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: There are none Date of last inspection 7 December 2004 Brief Description of the Service: Hillview is owned and operated by B&M Investments Limited, of Three Gables, Corner Hall, Lawn Lane, Hemel Hempstead, Hertfordshire HP3 9HN. 01442236020, and is registered to provide accommodation and care for up to 36 older people. Hillview 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. 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. Hillview is situated in a residential area of Ware, close to the town centre, with easy access to bus and rail services. Hillview I52 s19430 Hillview v228225 190505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home has recently lost the services of its handyman and its activities coordinator and on the day this inspection took place the relief cook was unable to work through ill health and so the assistant manager and other care staff had to step in and prepare the meals. Although recruitment for these vacancies is underway, the effect of the temporary reduction in the staff team was evident throughout the home. Staff had however successfully ensured that the personal care received by the home’s residents was not affected and both residents and visiting relatives and health professionals were quite positive about the standard of care provided. What the service does well: 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 Hillview I52 s19430 Hillview v228225 190505 Stage 4.doc Version 1.30 Page 6 contacting your local CSCI office. Hillview I52 s19430 Hillview v228225 190505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Hillview I52 s19430 Hillview v228225 190505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2,3,4,5 Hillview provides those people who are considering it as a home for themselves, or for someone they care for, the necessary information to enable them to make an informed decision. EVIDENCE: Those residents’ contracts seen appear to provide a clear statement of what is provided and what is not and what charges apply. Care plans include a pre-admission assessment that, if fully completed, should provide all the information required to ensure that a resident’s needs are known and can be met by the home. There is a system of regular reviews in place to take account of changes in need when they arise. Residents and relatives spoken to during this inspection were positive about the standard of care provided in Hillview. “I’ve been in three homes and this is the best” was one comment made by a resident. Hillview I52 s19430 Hillview v228225 190505 Stage 4.doc Version 1.30 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 Although the care plan format in use is quite comprehensive and detailed, the full benefit of it will only be obtained when there is a consistently thorough standard of completion of all parts. Medication practice is generally acceptable although the system of recording medication for return to the pharmacist has still not been adequately addressed. The provision of a suitable area for visiting health professionals to carry out routine health checks and consultations needs to be addressed so that residents’ privacy and dignity can be preserved. EVIDENCE: Care plans seen were not consistently completed. The returns records for medication no longer required does not provide a detailed, dated record of the medication awaiting return to the pharmacist at any time. There is an inconsistent pattern of recording for “as and when required medication” Hillview I52 s19430 Hillview v228225 190505 Stage 4.doc Version 1.30 Page 10 Painkilling ointment that had been prescribed for a deceased resident was found in a sitting out area adjacent to the dining room. The community nurse was using the conservatory area off the lounge for routine consultations. Hillview I52 s19430 Hillview v228225 190505 Stage 4.doc Version 1.30 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13 Residents are able to have visits and keep in contact within the local community if that is their wish. One centenarian said, “When you get older you mustn’t give up!” The programme of activities in the home is rather limited and depends in practice on members of care staff having the time to engage with residents either one-to one or in groups. “Bingo on Wednesday, nothing much else happens” was the comment of one resident. EVIDENCE: There is currently a vacancy for an activities organiser. The programme of regular activities is limited in content and frequency. There is no specific allocation of staff time to assist with activities, staff have to give priority to the personal care needs of residents and this means that time available to provide activities cannot be guaranteed. Hillview I52 s19430 Hillview v228225 190505 Stage 4.doc Version 1.30 Page 12 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 There are policies, procedures and staff training in place, which should, when fully met and applied provide a good standard of protection and security for residents. EVIDENCE: The home has a comprehensive adult protection policy and is aware of the Hertfordshire County Council protection of vulnerable adults procedure. Induction training for staff includes “whistle blowing” and consideration of the issues around abuse, how to recognise it and what to do if it is suspected. The home were not able to provide evidence during the inspection that one recently recruited member of staff had been subject to an enhanced level Criminal Record Bureau check. Hillview I52 s19430 Hillview v228225 190505 Stage 4.doc Version 1.30 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,22,23,24,25,26. Hillview is an older building, which has been well adapted to meet the needs of its residents and is kept well decorated and furnished. Residents are able to make their rooms their own by bringing items of furniture, pictures and ornaments with them. However the lack of storage space and staff facilities does now detract from the overall appearance of the home. EVIDENCE: The home has several areas, such as the conservatory, where things like table legs and cushions are now intruding. Some bathrooms have hoists and wheelchairs stored in them; the staff room was largely filled with wheelchairs and tins of food supplements, which made it difficult for staff to use as a rest area. The lounge area around the piano was cluttered with wheelchairs and frames and represented some risk to residents. Hillview I52 s19430 Hillview v228225 190505 Stage 4.doc Version 1.30 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29,30 Staff numbers appear to be adequate but should of course be kept under review to ensure that they remain adequate to meet the needs of all residents. Staff receive the training required to help them safely meet the needs of the home’s residents. It is disappointing that staff have to bear part of the cost of some more advanced training themselves. Recruitment policies and procedures, when followed in full, should provide residents with confidence that only those fit to be so are employed by the home. EVIDENCE: Staff over 25 years of age have to contribute towards the cost of NVQ level 3 training. A sample number of staff recruitment files were examined. The home were unable on the day of the inspection to provide evidence that an enhanced level Criminal Records Bureau application or POVA first check had been made in respect of one recently employed care- worker. Hillview I52 s19430 Hillview v228225 190505 Stage 4.doc Version 1.30 Page 15 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35,36,37,38 The home’s record keeping, policies and procedures, should, if and when fully completed and implemented make Hillview a safe place to live and work in. EVIDENCE: The standard of record keeping was found to be inconsistent. Staff spoken to and records seen confirm that supervision is now taking place at the required frequency and involves meaningful and positive exchanges of information. Those hoists and fire extinguishers seen had been appropriately maintained and serviced. There was one area where COSHH materials had not been correctly stored. Hillview I52 s19430 Hillview v228225 190505 Stage 4.doc Version 1.30 Page 16 The system of recording and accounting for monies held on behalf of residents was seen to be robust and those cash balances checked were correct. Hillview I52 s19430 Hillview v228225 190505 Stage 4.doc Version 1.30 Page 17 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 x COMPLAINTS AND PROTECTION 3 3 3 2 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x 3 3 2 2 Hillview I52 s19430 Hillview v228225 190505 Stage 4.doc Version 1.30 Page 18 YES 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 OP9 Regulation 13(2) Requirement The record of medication awaiting return to the pharmacist must enable the home to audit what is being held for return at any time, not just on a monthly or periodic basis. This requirement has been brougt forward. The detailed requirement was clarified with the Deputy Manager. The manager must carry out a review of the activities available to residents, consulting with them,(recording the results of those consultations), in order to establish if the current programme meets their needs and whether adequate staff time is available to ensure the delivery of a full and regular programme is realistic. Adequate storage areas must be provided for aids and equipment, including wheelchairs. The registered person must provide for staff appropriate and adequate facilities for the purpose of changing and storage, together with suitable rest areas. All materials covered by the Timescale for action From 19.5.05 and thereafter. 2. OP12 16(2)(n) By 31.8.05 3. 4. OP22(7) OP38 23(2)(m) 23(3)(a) By 31.8.05 By 31.8.05 5. Hillview OP38 13(3) From Page 19 I52 s19430 Hillview v228225 190505 Stage 4.doc Version 1.30 COSHH regulations(1988) should be locked away when not in use 19.5.05 and thereafter. 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 OP2 Good Practice Recommendations The format and content of residents contracts should be kept under review, and revised if necessary, to take account of any national guidance on good practice that may be issued. Care plan documentation should be reviewed to ensure that all sections are completed and that residents signatures are obtained for all parts where provision is made for this. The home should review the accommodation and facilities it provides for community nurses, to better enable them to offer routine consultations and minor treatment appropriately. The home should investigate current best practice in the provision of activities for older people in residential care settings. All records required for the protection of service users must be maintained, up to date and accurate. 2. OP7 3. OP10 4. 5. OP12 OP37 Hillview I52 s19430 Hillview v228225 190505 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Mercury House 1 Broadwater Road Welwyn Garden City, Herts AL7 3BQ 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. 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