Inspection on 14/02/06 for Hinderton Mount

This inspection was carried out on 14th February 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Hinderton Mount 13/01/09

Hinderton Mount 14/11/07

Hinderton Mount 11/01/07

Hinderton Mount 21/04/05

Hinderton Mount 21/10/04

Hinderton Mount 30/06/04

Hinderton Mount 10/02/04

Hinderton Mount 30/09/03

Hinderton Mount 12/09/02

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

CARE HOMES FOR OLDER PEOPLE Hinderton Mount Chester High Road Neston South Wirral Cheshire CH64 7TA Lead Inspector Helena Dennett Unannounced Inspection 14th February 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 Hinderton Mount DS0000006633.V286222.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. Hinderton Mount DS0000006633.V286222.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Hinderton Mount Address Chester High Road Neston South Wirral Cheshire CH64 7TA 0151 353 1619 0151 353 1619 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) Mrs Maureen Morton Mr David Morton Ms Eileen Town Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26) of places Hinderton Mount DS0000006633.V286222.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st April 2005 Brief Description of the Service: Hinderton Mount has been operating as a care home since 1985. It changed ownership in 1998 and is now owned and managed by Weatherstones House Care Limited. The home is an adapted property providing 26 places for older people. Located on Chester High Road, the home is within a mile-and-a-half of Neston town centre. There is also a local public house and service station (with shop) within walking distance for those service users who are ambulant. Accommodation for service users comprises twenty-two single and two double bedrooms, all having en-suite toilet/wash basin facilities. There are two lounges – one with a large conservatory extension – a separate dining room. The home has very pleasant and well-maintained gardens/grounds to the front and side, as well as adequate car-parking facilities. . Hinderton Mount DS0000006633.V286222.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 14th February 2006. The inspector toured part of the building, spoke to three residents two relatives and members of staff. Their comments are included in this report. What the service does well: What has improved since the last inspection? What they could do better: Although new care planning documentation has been introduced since the last inspection, further work is required to ensure that the needs of residents are identified and met. Hinderton Mount DS0000006633.V286222.R01.S.doc Version 5.1 Page 6 The recording on the administration of medication needs to be improved to ensure that all residents are given their medicines are prescribed. The manager of the home must make sure that all the necessary information is obtained before a person starts work at the home. Records of staff supervision should be kept. The health and safety of residents needs to be promoted, staff should discourage residents from placing heavy items on top of wardrobes, and wardrobes should be attached to prevent risk of falling. 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. Hinderton Mount DS0000006633.V286222.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hinderton Mount DS0000006633.V286222.R01.S.doc Version 5.1 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 the following standard(s): These standards were not assessed on this inspection. EVIDENCE: Hinderton Mount DS0000006633.V286222.R01.S.doc Version 5.1 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 the following standard(s): 7,8, 9 &10 Relatives said that staff meet the health care needs of the residents in the home and seek specialist advice when needed. Although each resident had a care plan in place, some of these did not cover all the identified needs and so there is a risk that residents needs may not be met. The recording of medicines is in need of improvement to ensure that residents are given their medication as prescribed. EVIDENCE: Residents said that they were well cared for. Relatives were happy with the care provided at the home. They said they are consulted when any changes happen. Three care files were examined as part of the inspection. These contained most of the information required. However, further work is required on the care plans to ensure that residents needs will be met at all times. For example in one care file there was no risk assessment done for the resident who had fallen out of bed twice. The resident’s mobility needs had changed but the care plan had not been updated to reflect the changes. Hinderton Mount DS0000006633.V286222.R01.S.doc Version 5.1 Page 10 Some entries were made in red pen. Black pen should be used for recording purposes as this will photocopy if required. Residents and Relatives were very positive about the care provided by staff at the home. One relative said that she felt her mother’s health had improved since she had been admitted to the home. Another relative said that her mother was a lot better since coming to the home, her mobility had improved and her appetite was much better. Residents said they felt their health and care needs are met by staff in the home. There was evidence in the care plans that GP’s are contacted if staff have any concerns about the health of a resident. The recording of medicines is in need of improvement to ensure that residents are given their medication as prescribed. A record of staff signatures was not available. Some residents keep their own medicines and a risk assessment is in place, however this should be revised to ensure it covers all areas of risk. On one residents Medicine Administration Record Sheet (MAR), several members of staff had signed to identify that they had given that medication daily, however this was an error as the medication was an injection to be given three monthly and had not been given by staff. It was also noted that signatures identifying that the medicine had been given were in place for some tablets that remained in the blister packs. The code O was used on some of the MAR sheets. If the code O is used staff should identify the reason for the omission. Staff should record on the MAR sheets the amount of medicines that are received and the date of receipt. See Requirement 1,2 & Recommendation 1 Hinderton Mount DS0000006633.V286222.R01.S.doc Version 5.1 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 the following standard(s): 12,13, & 15 There are enough activities provided to keep residents active and stimulated. Visiting can take place at any reasonable time so that residents can keep in touch with their relatives and friends. Meals are varied and balanced providing adequate nutrition for residents to keep them healthy. EVIDENCE: Residents were positive about the facilities in the home. They said they are kept active and stimulated. Relatives were also very positive. One relative said that she was extremely pleased that her relative is taking more interest in her surroundings and that there are enough activities going on to keep residents stimulated and happy. Records of activities are kept by staff in the home. Visitors said they could come and go as they please. They said that they feel welcomed by staff when they visit. The residents and relatives spoken with said that the food was ‘excellent’. One relative said that she is very happy that her relative was eating a lot more since she has come into the home. Hinderton Mount DS0000006633.V286222.R01.S.doc Version 5.1 Page 12 Lunch looked appetising apart from the liquidised diet which all of the food was liquidised together so it was difficult to identify what food was offered to the resident. See Recommendation 2 Hinderton Mount DS0000006633.V286222.R01.S.doc Version 5.1 Page 13 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): 16 Residents and relatives knew how to make a complaint if they needed to. EVIDENCE: There was a written complaints procedure for the home and relatives and residents were aware of their right to complain if they were unhappy with any aspect of the care or facilities provided at the home. No complaints have been received at the home since the last inspection Hinderton Mount DS0000006633.V286222.R01.S.doc Version 5.1 Page 14 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 The home was well maintained, decorated and furnished providing residents with a comfortable environment to live in. The front door now has a new lock in place to maintain residents safety. EVIDENCE: The home was well maintained. The lounges were well furnished and the bedrooms visited by the inspector were comfortable and personalised. The gardens were well maintained. The manager confirmed that a new lock has been purchased for the front door since the last inspection. This is to ensure that the safety of residents is maintained as the home is situated near a very busy road. The home was clean and tidy on the day of the inspection. Hinderton Mount DS0000006633.V286222.R01.S.doc Version 5.1 Page 15 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 & 29 There were enough staff on duty to meet the needs of the residents. An up to date CRB disclosure check was not in place for one member of staff and so residents could be placed at risk. EVIDENCE: Residents and relatives were very positive about the staff and their approach. Relatives said that there are enough staff on duty to meet residents needs. Comments such as ‘staff are lovely, have a great attitude ‘ were made. They confirmed that staff respond quickly to call bells thus making sure that residents needs are met. Residents also said that staff were ‘excellent’ Staff looked professional in their approach. A calm and relaxed atmosphere existed, there appeared to be a good rapport between members of staff and the residents. Recruitment records were examined. These contained most of the necessary checks required to ensure that staff employed are safe and suitable to work with elderly frail persons. However, it was noted that there was no up to date Criminal Record Bureau disclosure in place for one member of staff. The person had obtained a check when working at their last care home, however a new check had not been carried out. The home had been operating to out of date guidelines. A representative for the Registered person said that this would be addressed immediately. There was no completed application form in one persons file. See Requirement 3. Hinderton Mount DS0000006633.V286222.R01.S.doc Version 5.1 Page 16 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): 31,35 &38 The home is well managed and run for the benefit of the residents. A system is in place to manage residents’ money, which benefits residents. Records of supervision sessions are not kept so residents could be place at risk. Some health and safety issues were identified that require addressing to ensure that the health and safety of residents is maintained. EVIDENCE: The manager has worked at the home for a number of years. She is registered with the Commission for Social Care Inspection. Residents were positive about the manager and the staff working at the home. Hinderton Mount DS0000006633.V286222.R01.S.doc Version 5.1 Page 17 A small amount of residents’ money is kept. Receipts and records of transactions are kept. The system appears to be satisfactory Records of supervision are not been kept as required. This needs to be addressed. At the last inspection it was recommended that on site clerical support might assist the manager in the day-to-day running of the home. The responsible individual should consider increasing the number of supernumerary hours afforded to the manager so that she can concentrate on management tasks. Some health and safety issues were identified on this inspection. Suitcases, pillows etc, were stored on top of one wardrobe in a resident’s room. The wardrobe was not attached to the wall and could topple over causing an accident. This should be addressed. Fire drills and alarms have been tested and recorded regularly. Records of staff involvement in fire training and evacuation are also maintained. See Requirement 4 & Recommendation 2 Hinderton Mount DS0000006633.V286222.R01.S.doc Version 5.1 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 x 3 3 X X X X X X STAFFING Standard No Score 27 3 28 X 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 X X 2 Hinderton Mount DS0000006633.V286222.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? Yes 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 OP7 Regulation 15 Timescale for action Care planning and assessment 31/03/06 documentation for each service user must be reviewed regularly and up-dated where necessary. (Timescale 22/4/05 not met) Accurate records of medicines 14/03/06 administered to service users must be maintained. (Timescale 22/4/05 not met) Complete records of the checks 31/03/06 undertake in recruiting staff must be kept in the home A risk assessment must be 31/03/06 carried out on wardrobes containing heavy items. This should include the risk of falling on residents. Requirement 2. OP9 13 3 4 OP29 OP38 19 13 Hinderton Mount DS0000006633.V286222.R01.S.doc Version 5.1 Page 20 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 3 Refer to Standard OP7 OP15 OP31 Good Practice Recommendations An audit of care plans and medication records should be carried out. The chef should consider liquidising each item of food separately. The registered person should consider increasing the number of supernumerary hours available to the manager or the provision of clerical support to enable her to carry out all management duties. Records of staff supervision should be kept. 4 OP36 Hinderton Mount DS0000006633.V286222.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Hinderton Mount DS0000006633.V286222.R01.S.doc Version 5.1 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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