Inspection on 09/11/07 for Hilsea Lodge

This inspection was carried out on 9th November 2007.

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

Hilsea Lodge 21/04/06

Hilsea Lodge 11/10/05

Hilsea Lodge 27/01/05

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Hilsea Lodge London Road Hilsea Portsmouth Hampshire PO2 0TX Lead Inspector Nick Morrison Unannounced Inspection 9th November 2007 10:00 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 Hilsea Lodge DS0000044077.V355348.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. Hilsea Lodge DS0000044077.V355348.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hilsea Lodge Address London Road Hilsea Portsmouth Hampshire PO2 0TX 023 92 660152 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) www.portsmouthcc.gov.uk Portsmouth City Council Mrs Joan Patricia Tidd Care Home 35 Category(ies) of Dementia - over 65 years of age (35), Old age, registration, with number not falling within any other category (14) of places Hilsea Lodge DS0000044077.V355348.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st April 2006 Brief Description of the Service: Hilsea Lodge provides accommodation and personal care for up to thirty-nine older persons and is owned and managed by Portsmouth City Council Social Services Department. The home has recently registered a condition of registration with the Commission for Social Care Inspection, to accommodate seven residents with dementia in a wing of the home. The Commission has also been advised of longer term plans to develop the home into a specialist dementia care home. The home is single storey and is broadly divided into five units, all bedrooms are single occupancy. Each wing of the home has a dining and sitting area, and there is a large communal lounge in addition to this, and a specified smoking area. Service users have their meals in the dining rooms in the designated units, provided from the main kitchen by heated trolleys. There is recreational space outside, with seats, a fishpond and fountain. Gardens surround the home and consist of courtyards with shrubs, trees and plants; there is a lawned area also. Service users who use frames and wheelchairs are able to access the garden via ramps. The range of fees was not available at the time of this report. Hilsea Lodge DS0000044077.V355348.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report represents a review of all the evidence and information gathered about the service since the previous inspection. This included a site visit that occurred on 9th November 2007 and lasted six hours. During this time we went into each room, looked at service users’ files and met with people living in the home. We also met with the Deputy Manager and the Area Manager and spoke with five members of staff. All records and relevant documentation referred to in the report were seen on the day of inspection. We sent out surveys and received back four surveys from relatives, four from service users, three from staff and two from Care Managers. We have also referred to the Provider’s Annual Quality Assurance Assessment (AQAA). What the service does well: What has improved since the last inspection? What they could do better: Hilsea Lodge DS0000044077.V355348.R01.S.doc Version 5.2 Page 6 There are no requirements as a result of this inspection, but there were some areas identified with the Deputy Manager and Area Manager where they have acknowledged issues that need addressing. These are the regularity of staff support and supervision and the range and regularity of activities in the home, together with clear and up-to-date records of those activities. 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. Hilsea Lodge DS0000044077.V355348.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 Hilsea Lodge DS0000044077.V355348.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 6 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users benefit from having their needs assessed prior to moving into the home. EVIDENCE: Examination of service users files showed that each person living in the home had had an assessment of their needs prior to admission. Assessments were comprehensive and contained input from service users, their families and relevant health professionals. Families of service users and service users confirmed that they had been consulted during the assessment process. Families also confirmed that the home provided useful information prior to their relative moving into the home. Information about the home, including the Statement of Purpose, Service User Guide, Inspection Report and Complaints Procedure, was kept in the entrance to the home. Hilsea Lodge DS0000044077.V355348.R01.S.doc Version 5.2 Page 9 The home does not provide intermediate care. Hilsea Lodge DS0000044077.V355348.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 good This judgement has been made using available evidence including a visit to this service. Service users benefit from having their needs identified in a care plan and from having their healthcare needs met. They are protected by the home’s medication policies and procedures and are treated with dignity and respect. EVIDENCE: Examination of files showed that there were care plans in place for each service user. The plans had clearly been written in response to those needs identified in the pre-admission assessment, as well as to those needs identified as staff in the home got to know service users better. Staff spoken with said that the plans were accessible at all times and that they understood the care plans for each person living in the home. The plans were all reviewed on a monthly basis and changes made where necessary. Changes were also made to the plans in-between the monthly reviews if it was clear that needs had changed. Family members gave feedback that they were consulted about care arrangements and were kept fully informed of any changes. The healthcare Hilsea Lodge DS0000044077.V355348.R01.S.doc Version 5.2 Page 11 needs of service users were monitored daily and formally monitored on a monthly basis. Records were kept to demonstrate any changes in the person’s health and staff in the home liaised with other healthcare professionals whenever necessary. Family members said that staff in the home were attentive to the health needs of people living there and responded to any concerns and that they involved external healthcare professionals when necessary. GP’s confirmed that the home was good at seeking and following advice about health matters and that they were consulted about care plans. Care plans included risk assessments where necessary and these were also reviewed and updated on a regular basis and as necessary. Medication in the home was well managed. There was a clear medication policy and staff spoken with understood it fully. Staff involved in administering medication had all received training. All medication was stored safely and securely in the home and good records were kept of all medication administered. Records were also kept of all medication coming into and going out of the home. On the day of the inspection visit a service user asked the member of staff what medication she was being given and what it was for. The member of staff took the time to give a full and clear explanation to the person, which she was satisfied with. Observation throughout the inspection visit showed that staff understood how to respect the privacy and dignity of service users. Staff were courteous at all times to all service users and service users confirmed this. All service users seen and spoken with on the day of inspection were well presented and, where necessary, had support from staff to maintain their appearance. The induction training for staff provided them with guidance on the rights of service users and on ways to actively demonstrate respect and maintain peoples dignity. Service users had locks on their doors so that they could maintain their own privacy if they felt the need to. They also had lockable space within their rooms for their valuables. Staff observed on the day of the inspection always knocked and waited for a reply before entering people’s rooms. Hilsea Lodge DS0000044077.V355348.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 good This judgement has been made using available evidence including a visit to this service. Service users benefit from being able to exercise choice and control and have stimulating activities. They also benefit from good support in maintaining contact with friends and families and a good, balanced diet. EVIDENCE: Staff had received training in communicating with people who have dementia and were skilled in communicating with people living at the home. Service users’ methods of communication were recorded and there was close liaison with families over the needs, choices and wishes of each service user. Families confirmed that all the staff in the home were very good at communicating effectively with their relatives and that they were respectful of the choices they made. Observation of staff on the day of the inspection visit showed that they gave time and consideration to all service users and attempted to respond to their Hilsea Lodge DS0000044077.V355348.R01.S.doc Version 5.2 Page 13 wishes at all times. They spent time listening to people and engaging them in conversations. The records of activities in the home were not comprehensive. Not all activities taking place were recorded. Service users spoken with said they felt there was sufficient activity in the home some of the time, but that there were times when they felt there was not enough. Staff spoken with confirmed this and the Deputy Manager said they were aware of the need to increase activities for people and keep complete and accurate records. Visitors were encouraged to come to the home at any time and family members confirmed that they felt able to visit whenever they wanted to. Families said they were always made to feel very welcome in the home and that staff made it easy for them to visit and spend time with their relative. They said it was a very friendly and homely atmosphere and that they always felt welcome. Relatives were also encouraged to come into the home and have meals with the people living there and this was the case on the day of the inspection visit. The home also had a very positive attitude to addressing the nutritional needs of service users. On admission each service user had an assessment of their nutritional needs and individual nutritional care plans and risk assessments were devised in response to any issues highlighted in the assessment. Food was always served in the best way for each service user to consume it and staff were available to provide support for people who needed it. Fresh fruit was available for people. The meal seen on the day of the inspection visit corresponded with the menu for the day and people spoken with said they enjoyed the food in the home. Service users were involved in deciding what meals were on the menu and individual dietary requirements were catered for. Biscuits and cakes were available throughout the day. The home undertakes annual catering surveys and the results from these were analysed and there was clear evidence that menus had changed in response to the views of people living in the home. The home had also referred to up-to-date research on the dietary needs of people who have dementia in planning the meals and mealtimes within the home. There was staff support available to people who needed help with their food and staff took the time to explain the menu choices to people. Hilsea Lodge DS0000044077.V355348.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. Service users benefit from a clear and effective complaints procedure and are protected by the home’s adult protection procedures and practices EVIDENCE: The home has a clear and effective complaints policy in place. The policy is made available to service users and their families on admission and a copy is also available in the front entrance of the building. Families of service users were aware of the complaints policy and how to use it, but said they had never had to make a complaint. The home has a system in place for recording and responding to any complaints that may be made. Discussion with staff and examination of training records showed that all staff had received training in adult protection issues and were aware of their responsibilities within the adult protection procedures. The manager was clear about the reporting procedures and how to use them. The home had demonstrated in the past that it responds effectively and appropriately to incidents of suspected abuse. Hilsea Lodge DS0000044077.V355348.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. Service users benefit from living in clean, safe, well-maintained environment. Further work needs to be done to address the odour within the home. EVIDENCE: All parts of the building were kept very clean, but the home retained a homely and comfortable appearance. The furniture in the home was of very good quality and was replaced whenever necessary. There was also a programme of routine maintenance and records were kept to demonstrate that maintenance issues were responded to swiftly. The home employs adequate numbers of domestic staff to maintain the appearance of Hilsea Lodge DS0000044077.V355348.R01.S.doc Version 5.2 Page 16 the building. Domestic staff on the day of the inspection visit appeared conscientious and attended to details very well. Infection control policies were in place and were posted in places throughout the building to ensure that staff were able to refer to them throughout their work. The home had a very positive approach to infection control, including a hand rub available to staff and visitors so that people did not pass on any infection. Relatives and health professionals said the building was always maintained to a high standard. The home had replaced all the fire doors and were in the process of improving the garden areas for the people living in the home. There was an odour throughout the home. Records and discussion with the Deputy Manager showed that the home had done a number of things to tackle and improve the issue. Carpets were regularly cleaned and were replaced when new people moved into a room. Some rooms had alternatives to carpets in order to address the problem. There had been input from the continence nurse and staff had received training in continence issues. A ‘fogging machine’ had also been used to try to cover up the odour. Despite all these actions, the odour remained and the home needs to take further action in order to resolve the problem and maintain a comfortable environment for people to live in. Hilsea Lodge DS0000044077.V355348.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 good This judgement has been made using available evidence including a visit to this service Service users benefit from being supported by adequate numbers of sufficiently trained staff and are protected by the home’s recruitment policies and practices. EVIDENCE: The home employs sufficient numbers of staff to meet the needs of service users. Rotas showed that, in addition to this there were domestic staff including cleaners and a cook. Due to vacancies, the home was using some agency staff at the time of the inspection, but action had been taken to fill the vacant posts. All staff had very comprehensive induction training when they first began working in the home and clear records were kept of this. The ongoing training for staff was provided through a comprehensive training package. Staff spoken with said they had good access to all the training they wanted and were encouraged and supported to undertake as much training as possible. Families of service users said all the staff appeared to be very well trained and were competent in their roles. All staff in the home had, or were undertaking, NVQ level two or equivalent. Staff were receiving training input Hilsea Lodge DS0000044077.V355348.R01.S.doc Version 5.2 Page 18 on the new care planning system in the home. Further training included communication, sexuality, human rights and dementia care. Staff support and supervision had not been as regular as should it should have been over the past few months. This was partly due to gaps in the management team. The Deputy Manager and the Area Manager were aware of this and action was being taken to address the issue. Examination of recruitment records showed that the home ensured that all necessary pre-employment checks were in place for all staff before they were employed by the home. All staff were interviewed before being offered a job and clear records were kept of all interviews. Some members of staff had transferred to the home from other homes owned by the Provider. Some of these staff did not have references in place. The Deputy Manager said she would review all staff files to ensure they all contained the correct information. Family members said every member of staff were always very supportive and were always able to answer any questions or concerns they had. Hilsea Lodge DS0000044077.V355348.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): 31, 33, 35 and 38 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users are protected by the home’s financial procedures and by the management of health and safety issues. EVIDENCE: The Manager is registered and has the skills, knowledge and experience to manage the service. At the time of the inspection visit the Manager was on sick leave. The Area Manager explained interim arrangements and support being put in place. Service users had their own bank account and there was a system in place for accounting for money held on services users’ behalf in the home. The system Hilsea Lodge DS0000044077.V355348.R01.S.doc Version 5.2 Page 20 was thorough with regular checks taking place. Good records were kept of all transactions. Health and safety was well managed in the home. Comprehensive workplace risk assessments were in place and these were monitored and reviewed on a regular basis. The Deputy Manager was clear about health and safety legislation and specific regulations were accounted for within the home’s health and safety policies. Procedures for safe working practices were posted around the building and were covered in staff induction training. Staff spoken with were clear about the need for ensuring the health and safety of themselves, their colleagues and service users in all the work they undertook. Any incidents or accidents were recorded clearly and these records were regularly reviewed to ensure that practices were changed where necessary. All staff received regular training and updates in health and safety issues. All fire records within the home were up-to-date. Substances hazardous to health were well managed and stored safely. Staff had received information in controlling these substances. The laundry area was very well equipped and well managed. The home has a quality assurance system in place based on the views of people living in the home as well as their relatives and other stakeholders. Records were kept and showed that the service was responsive to the views of people with an interest in the service. Hilsea Lodge DS0000044077.V355348.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 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 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 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 X 3 X X 3 Hilsea Lodge DS0000044077.V355348.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO 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. Standard Regulation Requirement Timescale for action 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 Hilsea Lodge DS0000044077.V355348.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Hilsea Lodge DS0000044077.V355348.R01.S.doc Version 5.2 Page 24 - 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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