Inspection on 07/02/06 for Hillview

This inspection was carried out on 7th February 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hillview 13/08/09

Hillview 20/08/08

Hillview 13/12/06

Hillview 10/10/05

Hillview 14/02/05

Hillview 31/08/04

Similar services:

Insight - Eastchurch

Southfields

Thorndene

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Hillview 213b Eastbourne Road Polegate East Sussex BN26 5DU Lead Inspector Lucy Green Unannounced Inspection 7th February 2006 2:10 Hillview DS0000046904.V278591.R01.S.doc Version 5.1 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 DS0000046904.V278591.R01.S.doc Version 5.1 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. Hillview DS0000046904.V278591.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Hillview Address 213b Eastbourne Road Polegate East Sussex BN26 5DU 01323 488616 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) The Regard Partnership Limited Vacant Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Hillview DS0000046904.V278591.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated will be six (6). Only service users diagnosed with a learning disability to be accommodated. Service users will be aged between eighteen (18) and sixty-five (65) years on admission. 10th October 2005 Date of last inspection Brief Description of the Service: Hillview is a purpose built bungalow, situated just off the main A22 Polegate/Eastbourne Road. The home shares the same site as Oak Lodge, another service owned by this organisation. Local shops and public transport links are a short walk away. Service user accommodation provides six single bedrooms and a communal lounge. The bathrooms are fitted with the necessary adaptations. The home is registered to accommodate six younger adults with learning disabilities. Hillview is owned by The Regard Partnership. This organisation owns a large number of homes across England and Wales. Hillview DS0000046904.V278591.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulations 2001, uses the term ‘service user’ to describe those living in care home settings. For the purpose of this report, those living at Hillview are referred to as ‘residents’. This unannounced inspection took place over four hours on 07 February 2006. This is the second inspection of this year and therefore this report should be read in conjunction with the report from the unannounced inspection carried out on 10 October 2005. The purpose of this inspection was to assess compliance with the requirements of the previous inspection and to generally monitor care practices at the home. A tour of the premises took place, care and medication records were inspected. The Inspector met with five residents and six staff. Individual conversations were held with two residents and five staff members. What the service does well: What has improved since the last inspection? In line with requirements of the last inspection, evidence is now in place to demonstrate that recruitment procedures are sufficiently robust to protect residents. All staff now receive fire training at the required intervals. Hillview DS0000046904.V278591.R01.S.doc Version 5.1 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. Hillview DS0000046904.V278591.R01.S.doc Version 5.1 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 Hillview DS0000046904.V278591.R01.S.doc Version 5.1 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 the following standard(s): These standards were not assessed at this inspection, please refer to the report from the unannounced inspection carried out on 10th October 2005. EVIDENCE: Hillview DS0000046904.V278591.R01.S.doc Version 5.1 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 the following standard(s): 6&7 Residents influence and make choices about all aspects of their lives. The care planning process provides an outline of care needs and individual preferences. Residents would benefit if care plans included clear guidelines that detail how specific behaviours should be managed and therefore ensuring staff responses are consistent. EVIDENCE: Three care plans were viewed as part of the inspection process. All were found to be comprehensive, providing detailed information about how to support each individual resident in the preferred way. Each care plan contained a range of risk assessments, covering areas such as safety within the home, going on holiday and fire safety. It was however identified, that some risk assessments had not been implemented or updated to reflect changing needs. This was specifically noted for one resident who has begun wandering outside the home, where the risk assessment did not reflect the increased risk to safety. Similarly the manual handling of one resident is potentially a risk to both the resident and staff supporting him and therefore appropriate assessments should be in place. Hillview DS0000046904.V278591.R01.S.doc Version 5.1 Page 10 There are currently some specific behavioural issues that are not fully reflected in the care plan. From discussion with the staff on duty it was clear that staff were struggling to manage the behaviour of one resident and that there were no clear guidelines in place. It is required that appropriate guidelines be compiled to ensure all staff are able to respond to known behaviours consistently. Care plans contain a section for monitoring residents’ weights, it was noted in the care plans viewed that these were still not being regularly completed. It is again a requirement that residents are given the opportunity to be weighed and that the result is recorded, along with any necessary action that has been taken. During the inspection it was evident that residents are given choice and control over their lives and the way they spend their time. For example, residents would be routinely consulted about issues such as food, clothing and activities. Some residents at Hillview have limited verbal communication and therefore staff have to use other ways of ascertaining residents’ likes and dislikes. There was information in the care plan about individual’s communication methods and how individuals express their feelings. Throughout the inspection, staff were observed communicating effectively with the residents. Hillview DS0000046904.V278591.R01.S.doc Version 5.1 Page 11 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 the following standard(s): 16 Residents benefit from support that reflects both their rights and responsibilities. EVIDENCE: It was observed during the inspection that the home provides choice within daily living routines. There was documentary evidence that residents are able to make choices about their lives and how to spend their time. Residents have unrestricted access to all areas of the home, with the exception of other residents’ bedrooms and the laundry. Risk assessments are in place that highlight that all residents at Hillview need support to access the laundry safely and therefore this room is kept locked at other times. Residents are, where possible, encouraged to be involved in the general running of the home and participate in household activities. Two residents informed the Inspector that they help to with daily tasks, such as cleaning, washing and tidying their rooms. Hillview DS0000046904.V278591.R01.S.doc Version 5.1 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 the following standard(s): 20 Residents are protected by the systems in place to manage medication. EVIDENCE: Medication is stored, dispensed and administered appropriately. Staff spoken with confirmed that only those who had received training and supervision were permitted to administer medication. Hillview DS0000046904.V278591.R01.S.doc Version 5.1 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 the following standard(s): 22 Residents benefit from systems which allow their views to be heard. EVIDENCE: The home has a complaints procedure in place and ongoing systems to ensure residents’ views are listened to and acted upon. There have however, been no complaints made about the service at Hillview since the last inspection. Hillview DS0000046904.V278591.R01.S.doc Version 5.1 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 the following standard(s): 24 & 30 Residents benefit from a clean, comfortable and well maintained home. The physical adaptations enable service users to move safely and independently around their home. Residents would benefit from improved access to the garden. EVIDENCE: Hillview is a large purpose built bungalow which is well maintained and provides residents with sufficient private and communal space to meet their needs. Level access is provided inside the home, although it is required that access to the garden be improved. At the time of the inspection, the home was found to be clean and tidy throughout. Resident accommodation is provided in six single bedrooms which have been decorated and furnished to reflect the individual. Communal space comprises of a large lounge and a kitchen / dining area. Bathroom facilities are appropriately adapted. During the inspection it was identified that one resident has started to wander outside the home. The home is therefore required to review the security of the premises, including ensuring the main gate is shut at all times, to maintain a safe environment for all residents. Hillview DS0000046904.V278591.R01.S.doc Version 5.1 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 Residents benefit from a dedicated and competent team of staff to support them. Residents would be further protected if staff had the opportunity to undertake all mandatory training. EVIDENCE: Staff reported that The Regard Partnership has recently changed the way in which training is accessed. Internal trainers have now been appointed and staff confirmed that they had received some recent training. It was however identified that not all staff were up to date with their mandatory training, such as first. It is therefore required that staff have access to all required training and attend regular refresher courses to keep their skills and learning updated. Hillview DS0000046904.V278591.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38 & 39 The absence of a Registered Manager has negatively impacted on the running of the service. Formal review systems would be more reflective of residents’ wishes, if they were tailored to the needs of the user group. EVIDENCE: Hillview is currently without a Registered Manager, although the Inspector has been advised that a Manager from another service within the Organisation will be transferring to the home by March 2006. At the time of the inspection, the absence of this post was noticeable. The position of Registered Manager on this site covers both Hillview and its adjoining sister home, Oak Lodge. Both services have independent Deputy Managers who are currently leading their respective homes. From discussions with staff, it was evident that management direction on the site was lacking and as such the services are not working in partnership. This issue must be resolved before it impacts on the residents. Hillview DS0000046904.V278591.R01.S.doc Version 5.1 Page 17 The Regard Partnership has formal systems in place for the monitoring of quality assurance and there is an expectation by the organisation that these are carried out. As such, residents meet on a 1-1 basis with their key-worker each month to discuss a range of issues. Similarly regular residents’ meetings are conducted from which minutes are recorded. During the inspection, the Inspector questioned the quality of the feedback gained from using these methods. The type of information recorded was based more on staff observations and knowledge of the residents. Residents at Hillview have complex needs and for many, verbal communication is limited. As such, meetings appear to be an ineffective way of gaining residents’ views. This was discussed with the staff on duty at the time of inspection. All parties agreed that these systems did not really achieve their stated purpose. It was confirmed that the best feedback from residents was gained at the time of an event, meal or particular activity. All residents are able to communicate likes or dislikes at the actual time an event occurs. For many, it is difficult to remember such feelings and express them at a later date. It is therefore required, that the home review its systems for monitoring quality assurance and devise a system that is individual to the home and is actually an effective way of achieving the outcome of this standard. Monthly monitoring visits are also carried out on behalf of the Registered Provider and reports sent to the CSCI. At the current time these are not unannounced and this also needs to be addressed. Hillview DS0000046904.V278591.R01.S.doc Version 5.1 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 Standard No Score 1 X 2 X 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 X ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 3 X X 2 2 X X X X Hillview DS0000046904.V278591.R01.S.doc Version 5.1 Page 19 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 YA6 Regulation 15 & 13(4) Requirement Care plans to be regularly updated to be reflective of current needs and situations. This includes reviewing risk assessments and producing guidance for staff on how to manage identified difficult behaviours. Home to maintain a record of service user weights. (Previous timescale of 01 December 2005 not met) Policies and Procedures to reflect current guidance on the Protection of Vulnerable Adults. (Previous timescales of 01 December 2004, 01 February 2005 and 01 December 2005 not met) Action be taken to provide level access to the garden. (Previous timescale of 01/04/06 continues) Security of the home in respect of service users leaving unattended is reviewed. This to include the need for the main gate to be kept shut at all times. All new staff undertake an induction package which is in line with Skills for Care DS0000046904.V278591.R01.S.doc Timescale for action 01/04/06 2 YA19 17(1)(a) 01/03/06 3 YA23 14 & 13(6) 01/03/06 4 5 YA24 YA24 23(1)(a) 13(4) 01/04/06 20/02/06 4 YA32 18(1)(c) 01/04/06 Hillview Version 5.1 Page 20 5 YA39 24 6 YA39 26 specification. (Previous timescale of 01 December 2005 not met) That systems of reviewing 01/04/06 quality of service with service users is reflective of their strengths and needs. That the monthly monitoring 10/02/06 visits are conducted unannounced, in accordance with Regulation 26. 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 Hillview DS0000046904.V278591.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Hillview DS0000046904.V278591.R01.S.doc Version 5.1 Page 22 - 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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