Inspection on 29/12/05 for Hilton Rest Home

This inspection was carried out on 29th December 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.

Other inspections for this house

Hilton Rest Home 07/01/09

Hilton Rest Home 19/12/06

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 29th December 2005 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 Hilton Rest Home DS0000009497.V275212.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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.V275212.R01.S.doc Version 5.1 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.V275212.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th June 2005 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 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. The home was managed by Miss Julie Williams, who is an experienced manager of care homes for older people and who had gained the Registered Managers Award. A range of policies and procedures, which were in accordance with the National Minimum Standards for older people, underpinned the homes care practices. Hilton Rest Home gained the Investors in People Award in September 2001. Hilton Rest Home DS0000009497.V275212.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Summary of the Unannounced Inspection on the 29/12/05 This inspection was an unannounced inspection, the purpose of which was to assess important areas of life in the home that should be inspected over a 12 month period, check the progress of previous legal requirements and good practice recommendations, and check other matters in the home which came to the inspector’s notice. Most of the important matters in the home were assessed at the previous inspection and there was no need to assess again at this inspection The inspection took 7 hours, 15 minutes and comprised of, talking to residents, a tour of the premises, looking at resident’s care records and other documents, and discussion with the manager. Ten residents were spoken with, and others were observed in their routine daily activities. A member of staff and a relative were also spoken with. Comment cards were left in the home for residents and relatives to complete and return to the CSCI. Note The summary is particularly written for residents, and staff are asked to make sure some of the residents are able to read it or made aware of it. The home should also ensure that the full report is widely available to all those who are interested What the service does well: Residents are well cared for in the home. All residents spoken with stated that they were well cared for and that staff were caring and patient. Comments such as “nothing is too much trouble” and “staff are very kind” were made. One resident said the staff were like “angels of mercy” and that she was very grateful to them for looking after her. Another resident said “you couldn’t wish for a better place”. When asked if he was happy living in the home, one resident said “who wouldn’t be - living here”. Another resident relatively new to the home stated that the Christmas just past was the “best she had had for a long time” Hilton Rest Home DS0000009497.V275212.R01.S.doc Version 5.1 Page 6 Every effort is made to accommodate residents’ wishes and choices. One resident had been able to move by choice to a bigger room and could now receive visitors in greater comfort. 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 very good” 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 are committed to staff training and development and ensured that staff were trained in NVQ courses and other relevant courses. The target of 50 being trained to at least NVQ level 2 had been exceeded at the previous inspection. There was stable and continuity of management and support for the staff and residents. What has improved since the last inspection? All the previous legal requirements and recommendations, to improve practice and procedures, had been met. The written information about residents’ needs for care had improved, and details about residents’ diet and nutrition needs were now being recorded. The hot water system had been made safer and residents were less at risk from the dangers of water that is too hot. The way the details of the money spent by residents was recorded, had improved. Some parts of the home had been redecorated. Hilton Rest Home DS0000009497.V275212.R01.S.doc Version 5.1 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. Hilton Rest Home DS0000009497.V275212.R01.S.doc Version 5.1 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.V275212.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 4 & 5 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. The pre admission assessment procedure for those people having short term care could be improved. Residents’ needs were being met in the home. EVIDENCE: Records showed that an in house assessment was carried out prior to admission for most people recently admitted to the home. This in house assessment included all the matters listed in standard 3.3. Copies of the social work assessment had been obtained for those residents admitted through “care management” arrangements. After admission a care plan was generated. However for one resident on respite care there was no written assessment. Hilton Rest Home DS0000009497.V275212.R01.S.doc Version 5.1 Page 10 The registered person confirmed in writing to prospective residents that the home could meet their needs, and residents spoken with indicated that their needs were met. Residents spoken with stated that their needs were met at Hilton Rest Home and that they were well cared for. One resident who was recently admitted to the home said he “could not wish for a better place”. However several residents had some degree of confusion and memory loss and one resident was blind and had severe hearing impairment. Staff would benefit from specific training in these matters (see standard 30) 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. One resident spoken with confirmed that she had visited the home and had chosen to come and live there. She said she had settled in as well as could be expected and that “all the staff were very good”. Hilton Rest Home DS0000009497.V275212.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 & 11 The care plans had improved and contained useful information about the residents’ health, personal and social care needs. However some care plans would benefit from updating. 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. Residents who died were also treated with dignity and sensitivity. EVIDENCE: All residents had a written care plan informing care staff how to look after residents. Some aspects of them had improved since the previous inspection, and they contained some appropriate risk assessments, including one for the prevention of falls and vulnerability to pressure areas. There was a useful “social profile” section. The care plans were being reviewed approximately once a month and there was evidence that residents were involved in the compilation of their care plans. However for one resident whose records were viewed the care plan would benefit from updating with respect to mental Hilton Rest Home DS0000009497.V275212.R01.S.doc Version 5.1 Page 12 health / behavioural issues, and should include relevant risk assessments such as for alcohol consumption. 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. However as stated above the care plan of one resident would benefit from being updated in this respect. Pressure area care was managed appropriately, with advice and support from the district nurse as required. Appropriate information was recorded on the care plan. Residents’ weights were monitored and recorded, and since the previous inspection nutritional screening was being undertaken. Residents’ medication was well managed in the home. 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 some practices could be further improved and a number of legal requirements have been made. Residents said that their right to privacy was respected, and that staff treated them appropriately when giving assistance. One resident confirmed that staff respected her choice to spend most of the time in her room. 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. Discussion of the death of two residents with the manager, and looking at their records, indicated that the residents had been cared for properly and with sensitivity in their own rooms. Relatives had been suitably involved and staff had been able to attend the funerals. Hilton Rest Home DS0000009497.V275212.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 & 13 Routines were flexible enough to suit individual preferences. There were suitable activities enjoyed by the residents. Visiting arrangements encouraged and enabled residents to maintain contact with family, friends and the wider community. Visitors were made welcome in the home. 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 enabled to continue with their preferred religious observance, were given. These details of preferred routines were recorded on the care plans. Former hobbies and leisure interests were also recorded on the care plans, and these were encouraged. Leisure activities included games, entertainers and trips out. One resident organised a “domino school” and games were played most afternoons. Pictures of “old Burnley” and other old photographs were on the home’s notice board and stimulated reminiscence conversations. Residents spoke appreciatively about the Christmas and New Year activities. There had been parties, trips out and visiting choirs Residents and a relative spoken with confirmed that visitors were made welcome in the home at any time and that visits could take place in private. Residents were encouraged and enabled to have time out with relatives and Hilton Rest Home DS0000009497.V275212.R01.S.doc Version 5.1 Page 14 friends. One resident informed the inspector that she had a lot of visitors in the privacy of her own room, and was sometimes taken out to church functions. At the time of the inspection an aromatherapist and a hairdresser were working in the home. Hilton Rest Home DS0000009497.V275212.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The standards in this section were assessed at the last inspection and there were no related requirements or recommendations. They were therefore not assessed again at this inspection. EVIDENCE: The standards in this section were not assessed at this inspection. However there had been no complaints made since the previous inspection, and there had been no recent allegations or suspicions of abuse. Hilton Rest Home DS0000009497.V275212.R01.S.doc Version 5.1 Page 16 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 the following standard(s): 19, 20, 25 & 26 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. The hot water system had been made safer since the previous inspection. EVIDENCE: Hilton Rest Home DS0000009497.V275212.R01.S.doc Version 5.1 Page 17 The premises were well maintained and decorated, and certain areas of the home had been improved in 2005, for example more storage heaters had been covered to make them safer, and the emergency lighting had been replaced. Jobs were completed as and when required, and bedrooms were decorated as required and when they became vacant. 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 is electric storage heaters that can be controlled in the residents’ rooms. Since a previous inspection, and particularly in cold weather, these heaters are monitored and adjusted to ensure suitable temperatures. Residents spoken with stated that they had been warm enough over an exceptionally cold period. Covers for these heaters were gradually being fitted on a priority basis, and though not all were covered, risk assessments had been undertaken for those still without covers. Since the previous inspection further measures had been carried out to protect the residents from the hazards of hot water. Hot water taps in two bedrooms had been fitted with pre set valves to ensure water temperatures close to 43 degrees. A boiler had been adjusted to reduce the temperature at some outlets, and the hot water temperature at these and all other outlets were being regularly monitored and recorded. Risk assessments had also been completed. The home was clean and fresh at the time of the inspection with suitable laundry facilities sited in the basement. There were also suitable laundry procedures including those for the washing of foul and soiled laundry. Hilton Rest Home DS0000009497.V275212.R01.S.doc Version 5.1 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 & 30 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 over 50 of care staff had completed the relevant NVQ courses. However residents and staff would benefit from specific training relating to particular residents such as in sensory impairment. EVIDENCE: The staffing numbers and compliment in the home have consistently been suitable for meeting the needs of the residents. Residents, relatives and staff state they feel there are enough staff on duty. This was confirmed at the time of the inspection when it was noted that there was also a domestic and a cook working in the home. Residents praised the staff for their care. One resident stated that staff “were like angels of mercy”. Over 50 of care staff had completed relevant NVQ courses. In addition staff had completed courses in moving and handling, food hygiene, diabetes, medication management and first aid. The home’s in house Induction training programme was in accordance with the Skills for Care (the former TOPSS) specifications. Further staff training was planned in accordance with the needs of the staff and the residents, and at the time of the inspection carers had places booked on a “dementia” training course. Staff and one resident in particular would benefit from relevant staff undertaking training in sensory impairment. Hilton Rest Home DS0000009497.V275212.R01.S.doc Version 5.1 Page 19 The member of staff spoken with confirmed the training opportunities offered by the home. Hilton Rest Home DS0000009497.V275212.R01.S.doc Version 5.1 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35 & 38 The standards in this section were not inspected in full, but it was found that some legal requirements had been met to further safeguard residents monies, and to protect residents from water that is too hot. EVIDENCE: In relation to “Management and Administration”, only previous legal requirements were checked. With respect to residents’ monies, suitable records were now being kept of all financial transactions by and on behalf of residents. As stated earlier measures had been taken to further protect residents from water that is too hot. In addition a recommendation to record the names of the staff attending fire drills had also been met. Hilton Rest Home DS0000009497.V275212.R01.S.doc Version 5.1 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 2 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 x COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 x 3 3 X X X X 3 3 STAFFING Standard No Score 27 3 28 4 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X x Hilton Rest Home DS0000009497.V275212.R01.S.doc Version 5.1 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. 1 Standard OP3 Regulation 14&17(1) a sch31.a Requirement All residents, including those on respite care must only be admitted to the home following a comprehensive assessment that is documented The care plan of the resident identified must be updated with respect to mental health / behavioural issues and include relevant risk assessments such as for alcohol consumption. Risk assessments must be undertaken and reviewed with those residents who administer their own medication. Movical must not be used as a homely remedy without first consulting with the GP, and when prescribed for one resident must not be given to another as a homely remedy. Only care staff who have been trained by the District Nurse and certified as competent must take blood glucose tests, and this must be reviewed. Timescale for action 29/12/05 2 OP7 15 (2)(c) 31/01/06 3 OP9 13 (2) 31/01/06 4 OP9 13 (2) 29/12/05 5 OP9 13 (2) 31/01/06 Hilton Rest Home DS0000009497.V275212.R01.S.doc Version 5.1 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP30 Good Practice Recommendations It is recommended that relevant staff undertake training in sensory impairment. Hilton Rest Home DS0000009497.V275212.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB 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 Rest Home DS0000009497.V275212.R01.S.doc Version 5.1 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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