Inspection on 21/04/05 for Hinderton Mount

This inspection was carried out on 21st April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Hinderton Mount 13/01/09

Hinderton Mount 14/11/07

Hinderton Mount 11/01/07

Hinderton Mount 14/02/06

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 Anthony Groom Unannounced 21 & 22 April 2005 09:00 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. Hinderton Mount F51 F01 S6633 Hinderton Mount V222269 210405 Stage 4.doc Version 1.30 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 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 Eileen Town Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (OP) of places Hinderton Mount F51 F01 S6633 Hinderton Mount V222269 210405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21/10/04 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 - and 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 F51 F01 S6633 Hinderton Mount V222269 210405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection commenced at 9.45 a.m. on 21 April 2005 and was carried out over seven hours. A three-hour follow-up visit commencing at 11.00 a.m. was undertaken on 22 April 2005. On the first day of the inspection a senior care assistant and two care assistants were on the duty. On the second day of the inspection the manager, a senior care assistant and two care assistants were on duty. The Assistant Group Manager from Weatherstones House Care Limited attended for feedback on both days of the inspection. During the inspection a range of records was inspected and a partial tour of the premises was carried out. This included lounge, bathroom, corridor areas and six bedrooms. Seven service users, three relatives and two staff members were spoken with as part of the inspection process. What the service does well: What has improved since the last inspection? What they could do better: The home needs to consult with service users and introduce a regular and planned programme of activities. Record keeping within the home needs to be improved. In particular, this relates to care plans, the recording of complaints, staff recruitment and staff training records. Formal systems for the supervision and training of staff need to be introduced at the home in order to ensure their continued professional development. Hinderton Mount F51 F01 S6633 Hinderton Mount V222269 210405 Stage 4.doc Version 1.30 Page 6 Although service users’ views about the home are sought, consideration should be given to introducing systems for monitoring the quality of other aspects of the home’s operation. 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 F51 F01 S6633 Hinderton Mount V222269 210405 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 Hinderton Mount F51 F01 S6633 Hinderton Mount V222269 210405 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 and 5 The home provides information about the facilities and services offered to enable prospective service users and their families make informed decisions about moving into the home. The manager assesses all prospective service users before they move in to make sure that their needs can be appropriately met at the home. Hinderton Mount F51 F01 S6633 Hinderton Mount V222269 210405 Stage 4.doc Version 1.30 Page 9 EVIDENCE: A relative said that written information about the home, its facilities and services, had been provided before his relative moved in. The registered manager assesses all prospective service users before they move in. In addition to standard care management assessments (which were filed separately) the home has its own assessment forms which cover areas such as activities of daily living, physical and mental well-being, moving and handling, pressure sores and nutrition. Standard care management assessments need to be kept in service users’ main case file together with all care planning and other assessment information so that care staff can easily see all relevant information about each service user. See Recommendation 1 Prospective service users are encouraged to visit the home before making any decision to move in. One resident who had recently moved to the home from hospital said she had been happy for her relative to visit on her behalf and she was very pleased with the choice which had been made. Hinderton Mount F51 F01 S6633 Hinderton Mount V222269 210405 Stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10 Service users said they were satisfied with the way in which their care needs were being met. However, some care plans did not cover all the identified needs and this could result in inadequate care being provided. Care plans did not contain any evidence of consultation with service users (or their relatives/advocates) and this could result in misunderstandings and important information not being included. All service users spoken with confirmed that staff treated them respectfully. EVIDENCE: Six case files were checked as part of the inspection. Of these, three did not accurately reflect the current needs of the people concerned. There was no care plan for one resident and in the case of two others, whose needs had changed, the care plans had not been up-dated. The plans, therefore, did not detail their current needs and the interventions required by staff in order to meet these. There were also gaps in the monthly review of some care plans. Hinderton Mount F51 F01 S6633 Hinderton Mount V222269 210405 Stage 4.doc Version 1.30 Page 11 None of the care plans seen contained any evidence of consultation with service users or their relatives/advocates (i.e. a signature to indicate agreement with its contents) although the manager reported that such consultation does take place. Service users’ healthcare needs were being identified and monitored. Records of visits by community nurses and other healthcare professionals were being maintained. There are policies and procedures for handling and administering medicines safely in the home. Service users can administer their own medicines, subject to a risk assessment. One service user currently does this. The medicine administration record (MAR) sheets examined showed a start date of 16 May 2005, due to an error by the local pharmacy that had not been identified by staff at the home. The manager agreed to amend the MAR sheets and to ensure that this situation did not recur. See Requirements 1 & 2 Staff were observed to knock on service users’ bedroom doors and await permission before entering. Service users confirmed that this was normal practice and that they were always treated respectfully by staff. Hinderton Mount F51 F01 S6633 Hinderton Mount V222269 210405 Stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 and 14 Routines within the home appeared flexible and this enables service users to exercise choice and control over their individual lifestyles. Although there are some activities available, there is no regular planned programme of activities to keep residents stimulated. EVIDENCE: Service users expressed satisfaction with their quality of life within the home. One person said “the carers are very helpful and treat me with respect. I can’t find any fault with it and have absolutely no complaints”. Another commented that “the staff are very co-operative and helpful”, and a further said that the staff were “very kind”. There is no activities co-ordinator at the home and whilst staff arrange some activities for service users (e.g. bingo, exercises and sing-alongs) the frequency appeared to be variable and the range did not take fully into account the individual tastes and preferences of service users. This is an area which needs further development. See Requirement 3 Service users and staff confirmed that residents’ religious and spiritual needs are respected and that individuals are able to receive visits from clergy of their chosen religious denominations if they wish. Hinderton Mount F51 F01 S6633 Hinderton Mount V222269 210405 Stage 4.doc Version 1.30 Page 13 Service users are encouraged to maintain contact with their relatives and friends. They can receive visitors at any reasonable time and can meet their visitors in their own rooms or in the shared areas of the home. Service users said the day to day routines in the home are flexible and that they can make choices about how they spend their time. Examples of choice included: the times at which they retire to bed at night and rise in the morning, food and where meals are taken, clothing, personal care arrangements, spending time in their rooms, going out etc. Hinderton Mount F51 F01 S6633 Hinderton Mount V222269 210405 Stage 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 Service users and their relatives said they were aware of how to make a complaint but systems need to be developed to show that complaints are dealt with consistently. Residents are protected from harm and abuse by the home’s policies and procedures on dealing with abuse and staff confirmed they had received training on this. EVIDENCE: There was a written complaints procedure for the home and service users and relatives were aware of their right to complain if they were unhappy with any aspect of the care provided at the home. The home’s records of complaints was not always clear in detailing what action had been taken i.e. there were a number of past letters of complaint which were filed loosely in a sling file; in some cases there were copies of letters written in response to the complainants, but in others there were not. A full record of all complaints received (and action taken as a consequence) must be accurately maintained in the home. See Requirement 4 Written adult protection procedures had been compiled by the home and a copy of the local authority’s procedures and protocols was also available for staff to refer to. Two staff members (one of whom was an agency worker) confirmed that they had received some training in this area. Hinderton Mount F51 F01 S6633 Hinderton Mount V222269 210405 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 23, 24 and 26 The home is well maintained, decorated and furnished, providing service users with a comfortable, homely environment in which to live. There are well maintained and accessible garden areas in which service users can walk or sit. The homes un-gated main entrance is, however, next to a busy main road and poses a potential risk to some service users. EVIDENCE: The home is spacious, comfortable and homely and records show that there is a programme of routine maintenance to keep it in good order. Service users have a choice of shared spaces in which to sit and there is good access for people who use wheelchairs. All bedrooms have en-suite toilets and wash basins. Twenty-two of the twenty-six places are provided in single rooms, which provides most service users with privacy. The home is clean and odourfree, making a pleasant environment for service users and their visitors. There are pleasant, well-maintained garden areas (with garden furniture) for service users to use. Hinderton Mount F51 F01 S6633 Hinderton Mount V222269 210405 Stage 4.doc Version 1.30 Page 16 A visitor who arrived during the inspection reported that a service user was walking along the busy main road outside the home. The senior care assistant responded promptly and persuaded the individual, who was confused, to return to the home. This situation highlighted the potential risk that some service users face from a busy ‘A’ road being so close to the home. The home’s main entrance has an alarm fitted to alert staff when the door is opened but this had not been switched on. Action must be taken to ensure that the risk of vulnerable service users wandering out of the home without staff being aware of this is minimised. See Requirement 5 All the bedrooms in the home have en-suite facilities of toilet and washbasin and two also have showers. Service users are consulted about the layout of their rooms and are encouraged to bring in possessions such as pictures, ornaments and small items of furniture to personalise their rooms. Rooms seen during the inspection fully reflected the tastes and interests of their occupants. Service users can also pay to have their own telephones installed and a number had done so. Service users said they were satisfied with the quality of accommodation provided by the home. Hinderton Mount F51 F01 S6633 Hinderton Mount V222269 210405 Stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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, 28, 29 and 30 The home was taking steps to ensure that consistency of care was provided for service users but efforts to fill current staff vacancies need to continue. There is no evidence in the home to show that service users are being protected by thorough checks on staff being carried out before they start working there. EVIDENCE: Within the last eight months approximately seven staff have left the home. The company that runs the home is actively seeking to fill these vacancies. The agreed staffing levels for the home are currently maintained through existing staff working overtime and the use of agency staff. The home tries to use the same agency staff members wherever possible in order to promote consistency in service users’ care. Service users spoke positively about the care they received from staff. Two staff members have completed NVQ training at Level II and five are currently undertaking NVQ training (two at Level III and three at Level II). See Recommendation 2 The files for five staff members were examined and none contained evidence that two satisfactory references had been obtained or that satisfactory CRB disclosures had been received. These checks provide evidence that the home is checking that staff are suitable to work there. The Assistant Group Manager for the company that runs the home said two written references and CRB disclosures are always obtained for all staff who work at the home. Hinderton Mount F51 F01 S6633 Hinderton Mount V222269 210405 Stage 4.doc Version 1.30 Page 18 He thought there had been an administrative error in that copies of the relevant information had not been forwarded from the home’s head office and agreed to rectify this situation without delay. See Requirement 6 Some staff files showed that new staff undertake induction training to enable them to work more effectively with service users. There was no evidence, however, to show that there was a training and development programme for staff at the home See Recommendations 3 Hinderton Mount F51 F01 S6633 Hinderton Mount V222269 210405 Stage 4.doc Version 1.30 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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, 37 and 38 The home is generally well managed and the care provided for service users meets their needs. Service users commented positively about the home’s manager and staff team. However, there were problems with record keeping that could make it difficult to establish exactly what care was being provided for service users. Further work is needed on the systems which are used to monitor the quality of the service offered by the home. EVIDENCE: The home has an experienced manager who is currently undertaking NVQ Level IV training in management and care. Service users thought the manager was approachable and responsive to their needs. The home has carried out two surveys on the views of service users and the results of one survey (carried in 2003) were included in the home’s statement of purpose/service user guide. Hinderton Mount F51 F01 S6633 Hinderton Mount V222269 210405 Stage 4.doc Version 1.30 Page 20 There was, however, no evidence that formal quality monitoring systems covering other aspects of the home’s operation had been introduced. At the last inspection it was reported that formal supervision for care staff (at least six times per year) was being introduced; it appeared from discussion with staff that no further progress had been made in this area. See Recommendation 4 Record keeping on care planning, staff recruitment, staff training/development and complaints was inconsistent and inadequate. The manager acknowledged this but said that, due to staff shortages, her priority had to be to make sure that service users’ needs were being met. On site clerical support might help the manager develop more effective record keeping systems and should also release her from some routine administrative tasks (including answering many telephone calls), allowing her to concentrate on important areas such as reviewing care plans, staff supervision, training and development. See Recommendation 5 There was evidence to show that the manager was ensuring, so far as is reasonably practicable, the health and safety of service users and staff. Fire drills do, however, need to be recorded separately. Additionally, there is a need to ensure that vulnerable service users are protected from risks posed by the close proximity of a busy main road. See Requirement 5 Hinderton Mount F51 F01 S6633 Hinderton Mount V222269 210405 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 2 x 3 N/A 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 2 13 3 14 3 15 x COMPLAINTS AND PROTECTION 3 2 x x 3 3 x 3 STAFFING Standard No Score 27 2 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 3 2 x 2 x x 2 2 2 Hinderton Mount F51 F01 S6633 Hinderton Mount V222269 210405 Stage 4.doc Version 1.30 Page 22 NO 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 7 Regulation 15 Requirement Care planning and assessment documentation for each service user must be reviewed regularly and up-dated, where necessary. Care plans must also contain evidence of consultation with service users or their relatives/ advocates (or a reason stated where this is not practicable. Accurate records of medicines administered to service users must be maintained. A regular, planned programme of activities must be devised and implemented in full consultation with service users. Records of complaints received by the home, and any action taken as a consequence, must be accurately maintained on the registered premises. Action must be taken to eliminate the risk of vulnerable service users having unsupervised access to the busy main road which runs alongside the home. Complete records of the checks undertaken in recruiting staff must be kept in the home. Timescale for action 22/04/05 2. 3. 9 12 13 16 22/04/05 01/08/05 4. 16 17, 22 22/04/05 5. 20 13 22/04/05 6. 7. 29 & 37 19 22/04/05 Hinderton Mount F51 F01 S6633 Hinderton Mount V222269 210405 Stage 4.doc Version 1.30 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. 2. 3. 4. 5. Refer to Standard 3 28 30 36 37 Good Practice Recommendations All assessment documentation should be kept with service users care plans. A minimum of 50 of care staff should have completed NVQ Level II training by the end ogf 2005 A staff training and development programme should be introduced for all staff working at the home. Formal, recorded, supervision should be undertaken with all care staff at least six times per year. Serious consideration should be given to providing clerical/administrative support at the home. Hinderton Mount F51 F01 S6633 Hinderton Mount V222269 210405 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Unit D, Off Rudheath Way Gadbrook Park Northwich Cheshire 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 F51 F01 S6633 Hinderton Mount V222269 210405 Stage 4.doc Version 1.30 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. 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