Inspection on 19/12/06 for Hilton Rest Home

This inspection was carried out on 19th December 2006.

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

Hilton Rest Home 07/01/09

Hilton Rest Home 29/12/05

Hilton Rest Home 29/06/05

Hilton Rest Home 26/01/05

Hilton Rest Home 20/07/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Hilton Rest Home Quarry Street Padiham Burnley Lancashire BB12 8PH Lead Inspector Mrs Pat White Unannounced Inspection 19th December 2006 09:30 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 Hilton Rest Home DS0000009497.V318214.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. Hilton Rest Home DS0000009497.V318214.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hilton Rest Home Address Quarry Street Padiham Burnley Lancashire BB12 8PH 01282 775016 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) Mr Joseph Robb Buirds Mrs Marlene Joan Hyslop Buirds Miss Julie Williams Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places Hilton Rest Home DS0000009497.V318214.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Hilton Rest Home is registered to provide accommodation and personal care for 21 older people. The home is a detached premises set in a residential area approximately a quarter of a mile from Padiham town centre. The home is built on two levels, which are linked with a passenger lift; there are no internal stairs. Residents’ private accommodation is on both levels in 9 single bedrooms and 6 shared bedrooms. Four of the single bedrooms have an en suite facility. Shared space consisted of two lounges and a conservatory. The conservatory was used as a dining area. The lounge adjacent to the front door was a designated smoking area; all other rooms were smoke free. The main lounge could be partitioned to make two rooms. Fees charged per week ranged from £320 - £390, with extra charges for hairdressing, toiletries, newspapers/magazines, chiropody and holidays. Hilton Rest Home DS0000009497.V318214.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key unannounced inspection, which included a visit to the home, was conducted at Hilton rest home on the 19th December 2006. The purpose of this inspection was to determine an overall assessment on the quality of the services provided by the home. This included checking important areas of life in the home that should be checked against the National Minimum Standards for Older People, and checking the progress made on a few matters that needed improving from the previous inspection. The inspection included: talking to residents, touring the premises, observation of life in the home, looking at residents’ care records and other documents, and discussion with the manager Miss Julie Williams. Written information about the home, the Pre - inspection Questionnaire, (PIQ) was provided to the Commission before the site visit. Survey questionnaires from the Commission were sent to the home for residents and relatives to complete. The resident questionnaires had not been distributed at the time of the site visit and none had been returned at the time this report was being written. At the site visit five residents were spoken with in some depth, and others were spoken with as they joined in the Christmas party. Their views are included in the report. Some residents, who were unable to give their views about the home, were also spoken with. In addition three relatives were spoken with and 3 other relatives completed comment cards. Some of these views are also included in the report. Staff were not spoken with in depth on this visit, as this would have interfered with the organisation and the enjoyment of the Christmas party. What the service does well: Residents were well cared for in the home. All residents spoken with stated that they were well cared for, and that the staff were caring. Comments such as “nothing is too much trouble” and “staff are very kind” were made. One resident said, “you couldn’t wish for a better place”. One resident was very appreciative of the 50th wedding anniversary party that had been organised in the home. Some relatives described Hilton as “brilliant” and “home from home”. Hilton Rest Home DS0000009497.V318214.R01.S.doc Version 5.2 Page 6 Every effort was made to accommodate residents’ wishes and choices. One resident was able to use a shared room as a single room by choice and residents were encouraged and supported to continue with the interests they had before they entered the care home, for example, contact with the church and going to football matches. Residents have consistently praised the food served in the home, and it is commendable that there is a choice of two, cooked, lunch - time meals. At this inspection comments such as the “food is excellent” and “I never leave anything” were made. There were thorough and safe systems and procedures for the administration of medication to residents. The home provides a pleasant and comfortable environment for the residents, and some residents stated they liked their bedrooms. One resident said he “had everything he wanted in his room” including Sky TV. The home was well furnished and provided a pleasant and comfortable environment for the residents. The registered persons ensured that staff undertook relevant training so that staff had the right qualifications for working with older people. Most of the care staff (over 80 ) had gained the relevant National Vocational Qualifications (NVQs). There was stable and continuity of management and support for the care staff, that helped to ensure continuity of care and support for the residents. What has improved since the last inspection? Most of the legal requirements made at the previous inspection had been met, and in particular the medication procedures had been further improved to ensure the safe administration of medicines to residents. The home had a new fire alarm system and the fire precautions had been updated accordingly and following a fire safety inspection in February 2006. Some bedrooms had been decorated since the previous inspection. Hilton Rest Home DS0000009497.V318214.R01.S.doc Version 5.2 Page 7 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Hilton Rest Home DS0000009497.V318214.R01.S.doc Version 5.2 Page 8 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 Hilton Rest Home DS0000009497.V318214.R01.S.doc Version 5.2 Page 9 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): 1, 3 & 5. Standard 6 not applicable Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home’s admission procedures, including pre admission assessments and prior visits by prospective residents and relatives to the home, helped to determine whether or not the home could meet people’s needs. However the written assessments were not sufficiently comprehensive and detailed, particularly for those having short term care and must be improved. EVIDENCE: The written information about the home – the Statement of Purpose and the Service User Guide – had been reviewed and updated in 2006. Residents had copies of the Service User Guide in their bedrooms so that they were aware of this information. Relatives confirmed that they were also aware of this written information. Hilton Rest Home DS0000009497.V318214.R01.S.doc Version 5.2 Page 10 Records showed that an in house assessment was carried out prior to admission for most people recently admitted to the home so that staff would have some understanding of their needs. However not all these assessments included all relevant matters according to standard 3.3, and for one resident on respite care there was no comprehensive written assessment. This is outstanding from the previous inspection and must be addressed. Copies of the social work assessment had been obtained for those residents admitted through “care management” arrangements. Residents were given the opportunity of visiting the home prior to making a decision about whether or not Hilton Rest Home was the right home for them, and the manager met them and / or their relatives beforehand. Some relatives spoken with confirmed that they had visited Hilton Rest home and other homes, before making a decision on which they thought would be best. Hilton Rest Home DS0000009497.V318214.R01.S.doc Version 5.2 Page 11 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 & 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The care plans contained useful information about the residents’ health, personal and social care needs. However they did not contain sufficient detail on all these matters and some risk assessments did not contain sufficient up to date information to protect people. Residents’ health care needs were promoted and maintained. Medication procedures and systems ensured the safe handling, storage and administration of medication. Residents and visitors felt that residents’ rights to privacy and dignity in the home were upheld. EVIDENCE: All residents had a written care plan informing care staff how to look after residents. These included a useful “social profile” section that included residents’ preferences and reflected individuality and diversity. There was also evidence that care plans were being reviewed approximately monthly, and a Hilton Rest Home DS0000009497.V318214.R01.S.doc Version 5.2 Page 12 previous requirement to update one of the care plans with respect to mental health matters had been met. However the care plans viewed did not contain sufficient detail on all matters listed in standard 3.3 for example “oral care”, “foot care” and dementia related care, and there was no evidence for one resident whose records were viewed, that she or her relatives were involved in the compilation of the care plan. The residents’ health care, including psychological health, was promoted, and residents had access to all the necessary health care services. Some residents, whose care plans were viewed, were having all relevant support from the mental health services and district nurses. Pressure area care was managed appropriately, and with advice and support from the district nurse as required. This was supported by risk assessments and appropriate information on the care plan. Some residents’ weights were monitored and recorded, and nutritional screening was undertaken. However for one resident whose records were viewed there was no evidence that their weight had been monitored since 2003. To help protect residents there were written risk assessments for moving and handling, falls and the use of bedrails. However for one resident who was at risk of falling the relevant risk assessments needed to be reviewed and updated. For another resident with bedrails the risk assessment needed to be reviewed, updated and completed properly so that the risks are clearly identified and protection measures put in place. Residents’ medication was well managed and the previous legal requirements had been met. Good practices and procedures ensured the safe administration of medication to residents. There were suitable policies and procedures according to the Royal Pharmaceutical Society guidelines. Accurate records were kept of medications coming into the home, leaving the home and administered. Only those staff with appropriate training administered medication. However the medication of one resident who was administering his own medication was not always stored securely. Residents said that their right to privacy was respected, and that staff treated them appropriately when giving assistance. Residents stated that staff respected their choice to spend time in their rooms if they wished. The importance of respecting residents’ rights to privacy and dignity was included in the induction training for staff. A few residents had a private telephone line and phone in their rooms. However there were written instructions regarding the application and recording of creams on wardrobe doors. This was felt to diminish the privacy and dignity of the residents concerned. The manager agreed to rectify this at the time of the site visit. Hilton Rest Home DS0000009497.V318214.R01.S.doc Version 5.2 Page 13 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 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Routines were flexible enough to suit individual preferences. There were suitable activities enjoyed by the residents. The visiting arrangements encouraged and enabled residents to maintain contact with family, friends and the wider community. Residents were able to have certain choices in their everyday lives, and the meals served suited their preferences and were healthy and appetising. EVIDENCE: Residents confirmed that routines were flexible to suit their preferences. Examples such as having meals at a place of their choosing, going out alone and being supported to continue with their preferred religious observance, were given. These details of preferred routines, and former hobbies and interests were recorded on the care plans. Leisure activities listed on the Pre inspection Questionnaire, and discussed with the residents included, aromatherapy, movement to music, mobile library, church services, choir Hilton Rest Home DS0000009497.V318214.R01.S.doc Version 5.2 Page 14 singers, and entertainers. One resident organised a “domino school” and games were played most afternoons. At the time of the site visit there was a Christmas party with singer/entertainers, buffet tea and followed by carol singers from a local church. Relatives and visitors attended. Residents and relatives spoken with and those who completed comment cards confirmed that visitors were made welcome in the home at any time and that visits could take place in private. Two relatives spoken with and 3 who completed comment cards stated that communication between themselves and the staff was good. Residents were encouraged and enabled to have time out with relatives and friends. This was evident at the time of the site visit when visitors were enjoying the Christmas party with their relatives and friends. One resident spoke with pleasure at the 50th wedding anniversary party the home had organised and to which her relatives had been invited. Information was recorded about individual choices, preferences and preferred routines such as rising and retiring times. Residents stated in conversation that they had enough choice in such things as rising and retiring times and food. Residents could bring small items of furniture with them and could choose whether or not to manage their own finances. Menus showed that the food served was wholesome and varied, with a good mix of traditional foods. There was a choice of two main cooked meals at lunch - time with a choice of snack teas. Most residents ate in the conservatory, but some needing assistance ate in the lounge at individual tables. Nutrition assessments indicated whether or not residents required soft food. Residents praised the food. One stated it was “excellent” – just the right portions and “not over - facing”. Another said she, “always enjoyed the meals and didn’t leave anything”. The cook knew the residents’ likes and dislikes and tried different dishes according to requests. Hilton Rest Home DS0000009497.V318214.R01.S.doc Version 5.2 Page 15 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 & 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The complaints procedure was available to residents and visitors, and residents and relatives stated that they knew who to speak to if they had any concerns. However not all visitors felt confident that their concerns would be taken seriously. There were satisfactory policies and procedures to protect the residents from abuse and residents felt safe living in the home. EVIDENCE: The home had a complaints procedure, a copy of which was in the service user guide. Since the previous inspection one complaint had been made to the Commission about care issues and the environment. This had been passed to the registered provider to investigate. Examination of the home’s records indicated that the complaint had been investigated and a response made according to the home’s complaints procedure. However the tone of this response may not have reassured the complainant that her concerns were taken seriously. In conversation residents stated they had no complaints and expressed general satisfaction with life in the home. 3 relatives who completed comment cards stated that they were aware of the home’s complaints procedure but had never Hilton Rest Home DS0000009497.V318214.R01.S.doc Version 5.2 Page 16 had to make a complaint. Two relatives spoken with stated that they had no complaints and were very satisfied with all aspects of care in the home. One said the home was “brilliant”, but would have no hesitation in approaching the manager with concerns. However one relative stated that she could not discuss some concerns as she felt her concerns would be dismissed. Hilton Rest Home had policies and procedures to help protect residents from abuse. These policies and procedures were assessed at previous inspections, and the PIQ stated they were reviewed in 2006. There had been no recent allegations, or suspicions, of abuse. Residents stated they felt safe living in the home, and that they were well treated by staff. Hilton Rest Home DS0000009497.V318214.R01.S.doc Version 5.2 Page 17 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, 20, 24, 25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Hilton Rest Home provided pleasant, comfortable well maintained and clean private and communal accommodation that suited the residents’ needs. Refurbishment and renewal tasks were carried out in a planned and prioritised way. EVIDENCE: Hilton Rest Home DS0000009497.V318214.R01.S.doc Version 5.2 Page 18 The premises were well maintained and decorated, and certain areas of the home had been improved in 2006, for example some bedrooms had been decorated and the fire alarm system had been replace making the home safer. Maintenance jobs were completed as and when required, and bedrooms were decorated when they became vacant if need be. There were car-parking facilities at the front of the building, and outdoor areas to the front and rear of the building, which service users could use in fine weather. The communal space consisted of a two - part lounge, a conservatory that was used as a dining room, and a small lounge used for smoking by residents and staff. All these areas were bright, pleasantly decorated and furnished. The home’s heating system was electric storage heaters that can be controlled in the residents’ rooms. Some of these heaters were fitted with covers others were not. However risk assessments had not been completed for all residents who were in bedrooms without heater covers, so there was no written evidence to demonstrate that these residents were not at risk from hot surface temperatures. Hot water outlets tested in all areas of the home showed hot water temperatures were within an acceptable safe range. The maintenance book showed that water temperatures were tested every month. The home was clean and fresh at the time of the inspection. Suitable laundry facilities were sited in the basement. At the previous inspection it was established that there were also suitable laundry procedures including those for the washing of foul and soiled laundry. Hilton Rest Home DS0000009497.V318214.R01.S.doc Version 5.2 Page 19 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 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had sufficient staff on duty to meet the needs of the residents. The staff training programme was being developed according to the needs of the residents and staff, and a large proportion of care staff had completed the relevant NVQ courses. However residents and staff would benefit from specific training relating to particular groups of residents such as in dementia. Staff recruitment procedures helped to protect residents from unsuitable staff, but further information about applicants needs to be obtained. EVIDENCE: According to the inspection methods used, including the staff rotas, discussion with the residents and observation at the time of the site visit, the staffing levels in the home appeared to be satisfactory. At the time of the visit there was extra staff on duty for the Christmas party and a cook and cleaner were working in the home. Four relatives stated that they thought there was “always enough staff on duty”. However one relative stated on a comment card that there was not always enough staff on duty and one was concerned about the level of supervision at night. Hilton Rest Home DS0000009497.V318214.R01.S.doc Version 5.2 Page 20 Staff were completing training courses according to Government guidelines. The PIQ stated that 12/15 care staff were qualified to at least NVQ level 2, that is 80 . The manager confirmed at the site visit that all but one member of staff had a relevant NVQ. In addition the PIQ and staff training records showed that staff had completed courses in moving and handling, food hygiene, first aid, medication and fire training. The home’s “in - house” Induction training programme was in accordance with Government guidelines. However a dementia care course that was booked at the time of the last inspection did not take place due to problems with the training provider. There were several residents with a diagnosis of dementia and memory loss. Training in dementia would benefit both residents and staff. The staff group reflected the cultural and racial background of the residents. The records of two members of staff who had commenced work since the previous inspection were looked at. These showed that staff were not commencing work in the home until the necessary police checks had been completed and satisfactory references had been received. Records also showed that new members of staff completed an Induction training course that helped them gain the knowledge and skills to carry out their work. However one person had not given a detailed employment history, with dates of employment, and the application forms viewed did not contain a complete section on “declaration of criminal convictions”. Hilton Rest Home DS0000009497.V318214.R01.S.doc Version 5.2 Page 21 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 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was well managed by an experienced and stable manager and staff team. The home had quality assurance measures that took into account the views of residents and relatives. In general the health and safety of the residents and staff were promoted but some further improvements could be made, for example the response to accidents. EVIDENCE: The registered manager had worked as the manager in the home for a number of years and had the relevant qualifications, skills and experience. She worked Hilton Rest Home DS0000009497.V318214.R01.S.doc Version 5.2 Page 22 shifts with the staff and is therefore accessible and knows the staff and the residents. She had specific designated “admin hours”. The manager confirmed that she had undertaken updated fire training based on the new fire alarm system and medication training. The registered providers visited the home frequently and supported the manager. Residents and relatives benefited from a stable management and staff team. The home had internal service quality monitoring methods that involved questionnaires to residents and relatives. This leads to an annual quality management review report, the last one of which was forwarded to the Commission. Residents and relatives were encouraged to manage residents’ finances, including spending money. However for those residents who cannot manage their finances, and have no relatives to do this, the registered provider will act as appointee, and appropriate records were kept in the home regarding fees and spending money. For one resident a some of money was held securely in the office safe and balanced with the records kept of money received and money spent. The home in general was a safe place for residents and staff to live and work. The maintenance records viewed in the home confirmed the information given on the PIQ - that all maintenance and servicing of installations, appliances and equipment had been carried out appropriately. The manager carried out weekly health and safety audits of the premises. However it was not clear that all residents were protected from uncovered heaters (see standard 25). Nearly all staff had undertaken appropriate health and safety training, such as first aid training, moving and handling and food hygiene. The fire precautions and equipment had been updated and improved since the previous inspection. A new fire alarm system had been installed and the recommendations of a fire safety inspection by the fire service had been implemented. Records showed that satisfactory fire precautions were carried out. Accidents, including falls were recorded in a way that was compliant with Data Protection recommendations. However an accident report for a resident whose records were viewed and which indicated a fall had occurred could not be found. Also records showed that the Commission had not been notified of all falls that had resulted in admission to Accident and Emergency, and of all the residents who had died. Hilton Rest Home DS0000009497.V318214.R01.S.doc Version 5.2 Page 23 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 3 X 2 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 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 2 17 X 18 3 3 X X x 3 3 2 3 STAFFING Standard No Score 27 3 28 4 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 X 3 X X 2 Hilton Rest Home DS0000009497.V318214.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Two 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 OP3 Regulation 14&17(1) a sch31.a Requirement All residents, including those having respite care must only be admitted to the home following a comprehensive assessment that is documented and covers all matters listed in standard 3.3 (Previous timescale of 29/12/05 not met) Timescale for action 31/01/07 2. OP7 15 (1) 3. OP7 15 (1) 4. OP8 13 (4)(b) & (c) The care plans must contain 28/02/07 sufficient detail in all matters of personal, health and social care to ensure that staff understand what needs to be done, and how, to meet these needs, including “oral care and “foot care. The residents and/or their 31/01/07 representatives must be involved in the preparation of, and agree to the contents of, the care plan The registered person must 31/01/07 ensure that any risks associated with daily life and activities are as far as possible eliminated and appropriate risk assessments must be completed, reviewed and updated, including risk assessments for falling, moving and handling and the use of bed DS0000009497.V318214.R01.S.doc Version 5.2 Page 25 Hilton Rest Home 5. OP25 13 (4)(a) 6 OP29 19(1), schedule 2 & 17(2) 7 OP38 37 (1) (a) (c) & (e) rails. The registered person must ensure that residents are protected from hot surface temperatures through, either ensuring that the heaters are covered or that risk assessments demonstrate that the risk has been eliminated. (This has been outstanding at a number of inspections) The registered person must ensure that all staff recruitment records are obtained before staff commence work according to the Regulations, including a completed employment history, with dates and an explanation of any gaps in employment and a completed signed “declaration of criminal activities”. The manager must ensure that all accidents, including falls are recorded appropriately and that the Commission is notified in writing. She must also ensure that the Commission is notified of all the deaths in the home. 28/02/07 31/01/07 31/01/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP8 OP16 Good Practice Recommendations It is recommended that all residents have their weight monitored and recorded. The registered person should ensure that the culture in the home is one that encourages relatives and residents to express their concerns with confidence that these concerns will be dealt with appropriately. It is strongly recommended that staff undertake training in DS0000009497.V318214.R01.S.doc Version 5.2 Page 26 3. OP30 Hilton Rest Home dementia care as soon as possible. Hilton Rest Home DS0000009497.V318214.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB 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 Hilton Rest Home DS0000009497.V318214.R01.S.doc Version 5.2 Page 28 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!