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Inspection on 25/04/05 for Hilton Park Care Centre

Also see our care home review for Hilton Park Care Centre for more information

This inspection was carried out on 25th April 2005.

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

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Hilton Park provides high quality accommodation in two units within attractive and well-maintained gardens. It has an excellent activities program with activities provided for service users of all ages and capabilities. The unit for younger adults strives to make life full and interesting and the manager and staff are open to any ideas put forward by those involved in and using the service. Staffing levels are good and accommodation is available for staff. Training is available for all grades of staff.

What has improved since the last inspection?

A new terrace has been created for service users use. Several areas of the home have been redecorated, refurnished and new carpets fitted. Staff recruited from overseas have a full induction into the country at company level before being allocated to the home. This induction includes any different cultural implications when caring for clients.

What the care home could do better:

A service user guide specific to the needs of younger adult service users that contains information about activities directed at this group would be beneficial. Their social aspirations are vastly different from elderly people. Staff should work toward identifying service users who may be able to manage their own medication. This should be clearly stated in the care plan.

CARE HOMES FOR OLDER PEOPLE Hilton Park Care Centre Bottisham Cambridge CB5 9BX Lead Inspector Jenny Cangy Unannounced 25 April 2005 @ 11:00 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. Hilton Park Care Centre I53 I03 S38514 HILTON PARK CARE CENTRE V223414 250405 STAGE 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Hilton Park Care Centre Address Bottisham Cambridgeshire CB5 9XB 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) 01223 811256 Barchester Healthcare Homes Ltd Paul Walsh Care home with Nursing 93 Category(ies) of Older People 55 Physical disability(Elderly) 15 registration, with number Dementia(Elderly) 55 Physical disability 23 of places Mental disorder(Elderly) 55 Hilton Park Care Centre I53 I03 S38514 HILTON PARK CARE CENTRE V223414 250405 STAGE 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 09/11/04 Brief Description of the Service: Hilton Park Care Centre is owned by Barchester Healthcare Homes Limited and is registered as a care home with nursing. The home is situated in the village of Bottisham and is 7 miles from the centre of Cambridge and 6 miles from Newmarket. The home is divided into two units the ‘Cambridge Suite’ and ‘Newmarket Suite’. Both Suites consist of two floors and there are shaft lifts to the upper floors. There are 91 single bedrooms and one double bedroom, all of which have en-suite facilities. Within the Newmarket suite is a unit for 12 young physically disabled adults. The home is registered to provide care to 23 Younger Adults with physical disabilities. Hilton Park Care Centre I53 I03 S38514 HILTON PARK CARE CENTRE V223414 250405 STAGE 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector conducted her unannounced visit over 7.5 hours. The Inspector met with the Manager and spent time assessing the record keeping and information available for the benefit of staff and service users. She also gained information on training available to staff. The manager and the inspector discussed recent incidents that have been reported. They also discussed the effect that Barchester Healthcare’s recent take over of the Westminster Healthcare group may have on the day-to-day running of Hilton Park. The manager believed there would be no changes that would affect the service users. The inspector toured the home and spent time talking to staff, service users and visitors. The inspector found all areas of the home to be clean, fresh and well decorated. Many parts of the home have been upgraded in the past year and further upgrades are planned. The inspector found the home to be well staffed. She met with service users, staff and visitors. She spent time with two service users who wished to voice concerns. These concerns were later discussed with the manager. While the inspector acknowledges that the service users who are younger adults have a specific program of activities and appropriate social lives this is not identified in the statement of purpose and service user guide. The current guides are generally written for the larger group of older people occupants of the home. A service user guide specifically aimed at the younger adult group would give prospective service users more information prior to moving into the home, thus enabling them to better judge if the home is suitable for their needs. What the service does well: What has improved since the last inspection? Hilton Park Care Centre I53 I03 S38514 HILTON PARK CARE CENTRE V223414 250405 STAGE 4.doc Version 1.30 Page 6 A new terrace has been created for service users use. Several areas of the home have been redecorated, refurnished and new carpets fitted. Staff recruited from overseas have a full induction into the country at company level before being allocated to the home. This induction includes any different cultural implications when caring for clients. 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. Hilton Park Care Centre I53 I03 S38514 HILTON PARK CARE CENTRE V223414 250405 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 Hilton Park Care Centre I53 I03 S38514 HILTON PARK CARE CENTRE V223414 250405 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) 1, 3 & 4 Prospective service users have adequate information provided about the service. However as the social needs of younger adults may greatly differ from those of older people and there is no separate service user guide for the younger adults and the inspector considers that a specific service user guide for this group is necessary. All service users are assured their care needs can be met. EVIDENCE: A copy of the statement of purpose and service user guide is given to all prospective service users and displayed in the reception area. The National Minimum Standards for younger adults are attached to the guide that is given to client under 65 but there is no separate service users guide. All prospective service users have a full assessment of their needs conducted by a senior member of staff before being offered a place. This assessment forms the basis of the individual care plan. Service users are sent a letter confirming their needs can be met. Hilton Park Care Centre I53 I03 S38514 HILTON PARK CARE CENTRE V223414 250405 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 Service users healthcare needs are known and met. A full record is retained in the individuals care plan. Medication records are well maintained and staff administering medication are trained to do so. Service users are not given the opportunity to look after their own medication. EVIDENCE: All service users have a comprehensive plan of care that is regularly updated as their care needs change and reviewed monthly. All activities are risk assessed to assure the well being and safety of the service users. Risk assessments are included in the care plans. Service users are registered with a local GP who does weekly visits to the home for routine reviews of the service users and visits as needed in between times. The home has a visiting optician service and dental treatment can be arranged as required. The home uses a Monitored Dose System (MDS) of medication storage, recording and administration. The inspector found medication records to be accurate and up to date. Staff have training from the supplier in the management of the MDS. system. Service users have lockable facilities in their bedrooms to store their own medication but there is no evidence of service users being offered this choice. Hilton Park Care Centre I53 I03 S38514 HILTON PARK CARE CENTRE V223414 250405 STAGE 4.doc Version 1.30 Page 10 Hilton Park Care Centre I53 I03 S38514 HILTON PARK CARE CENTRE V223414 250405 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) OP 12, 13 & 14 YA 11, 12 14 & 15 There is a range of daily activities for service users to participate in. The garden is well-kept and accessible to service users. Visiting is permitted at any time within reason and activities take place both within the home and in the local community. Service users are able to make choices in their daily lives. Personal relationships are supported. EVIDENCE: There are activity programs for all service users displayed on notice boards around the home. Separate activities are available for the younger adults and there is transport available. Some of the younger adults are able to have guests overnight if they wish providing the management has prior notice. Privacy is respected. The inspector noted that some service users have computers with access to the inter-net. The inspector met and talked to several visitors during her tour of the home. Hilton Park Care Centre I53 I03 S38514 HILTON PARK CARE CENTRE V223414 250405 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 Service users have the information they need to know how to make a complaint and the home has a complaint procedure. Service users legal rights are protected. The home has an adult protection procedure to prevent abuse and staff have a good knowledge and understanding of what constitutes abuse and how to deal with it. EVIDENCE: The complaint procedure is displayed on notice boards around the home and is also contained in the service user guide. It has information on how to make a complaint and what to do if not satisfied with the outcome of the complaint. Service users are registered on the electoral roll and have postal votes organised if the want them. The management will facilitate solicitors’ visits if any service user needs to see one. All staff receive training in recognising and preventing abuse and the home has a Protection of Vulnerable Adults (POVA) policy. The manager has notified the POVA team of any problems identified in the past. Hilton Park Care Centre I53 I03 S38514 HILTON PARK CARE CENTRE V223414 250405 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, 22, 25 &26. All areas of the home were clean, fresh and well decorated. Communal areas are bright and spacious with a variety of rooms available to service users. There are attractive gardens for service users to access. Aids and equipment are provided as needed by the individual. The accommodation in the home is maintained to a high quality and creates a comfortable, safe environment for those living there. EVIDENCE: The inspector found no unpleasant odours during her tour of the home. She noted many areas have been refurbished including new carpets décor and furniture. Further refurbishment is planned and eventually the whole home will have been refurbished. A new terrace with garden furniture has been created in readiness for the summer. Risk assessments cover all areas of the home and staff have training in health and safety matters to assure the safety of the service users. Hilton Park Care Centre I53 I03 S38514 HILTON PARK CARE CENTRE V223414 250405 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&30 The home is well staffed with Nurses, Carers, Domestic, Catering and administrative staff. The home provided accommodation for staff who do not live locally. The home also has administrative staff. There is a continuous program of staff training. EVIDENCE: The inspector spoke with all grades of staff during her tour of the home. Staff were noted to be plentiful and actively engaged with service users around the home. Staff recruited from overseas undergo a company induction into the country and culture before being placed at the home where they have a full induction training package. The company provides staff accommodation on site. All service users have a named nurse and key worker so they and their families know who to talk to if there is a problem. Hilton Park Care Centre I53 I03 S38514 HILTON PARK CARE CENTRE V223414 250405 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) 31, 33, 36 & 38. The manager of the home is well qualified and sees staff and service users regularly. Service users are consulted about their views and the quality of care they receive. Health and Safety of staff and service users is important. Staff of all grades have regular supervision and assessment of their training needs. EVIDENCE: The manager is a first level registered nurse and is degree qualified in management of care. The inspector noted that he is known to staff and service users and the atmosphere is relaxed and informal in his presence. The home has regular service user meetings to gain their views and has a quality assurance program where service user complete questionnaires. The area manager also conducts quality audits during her monthly visit to the home. There are regular heads of unit meetings and a health and safety committee that audits any accidents. Hilton Park Care Centre I53 I03 S38514 HILTON PARK CARE CENTRE V223414 250405 STAGE 4.doc Version 1.30 Page 16 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 2 x 3 2 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 x COMPLAINTS AND PROTECTION 4 3 x 3 x x 3 3 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 4 x 3 x x 3 x 3 Hilton Park Care Centre I53 I03 S38514 HILTON PARK CARE CENTRE V223414 250405 STAGE 4.doc Version 1.30 Page 17 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 1 Regulation 4&5 Requirement Timescale for action by 30th June 2005. 2. 9 OP 20(1)YA 12(2) 13(2) The registered person must compile a statement of purpose and service user guide that relates to and is specific to the services offered and the needs of Younger Adults with a Physical disability. By 30th The registered person must demonstrate that service users June 2005 are offered the option to administer their own medication within a risk assessment framework. The registered person must have in place a method by which service users are assessed regarding their ability to administer their own medication. This must be clearly recorded in the care plan. 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. Hilton Park Care Centre I53 I03 S38514 HILTON PARK CARE CENTRE V223414 250405 STAGE 4.doc Version 1.30 Page 18 Refer to Standard Good Practice Recommendations Commission for Social Care Inspection CPC1, Capital Park Fulbourn Cambridge CB1 5XE 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 Hilton Park Care Centre I53 I03 S38514 HILTON PARK CARE CENTRE V223414 250405 STAGE 4.doc Version 1.30 Page 19 - 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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