Inspection on 29/07/05 for Hill House

This inspection was carried out on 29th July 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hill House 31/10/06

Hill House 03/03/06

Hill House 25/02/05

Hill House 31/08/04

Similar services:

Ruskin Lodge

Dystlegh Grange

The Good Companions

Springfield Cottage

Cuerden Grange Rest Home

Cornmill Nursing Home

Vitalise Sandpipers Centre

Sue Ryder Care Birchley Hall

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

CARE HOME ADULTS 18-65 The Hill Newcastle Road Sandbach Cheshire CW11 1LA Lead Inspector Joan Adam Unannounced 29 July 2005 9.00am th 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. The Hill F51 F01 S18792 The Hill V234981 290705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Hill Address Newcastle Road Sandbach Cheshire CW11 1LA 01270 762341 01270 527414 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) Leonard Cheshire/Mr Michael OLeary Mrs Jean Parry Care Home with Nursing 33 Category(ies) of Physical disability - 33 registration, with number Physical disability over 65 years of age - 6 of places The Hill F51 F01 S18792 The Hill V234981 290705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 33 service users to include: Up to 33 service users in category of PD (physical disability aged 18 to 64 years) Within the maximum number of 33, up to 16 service users in the category of PD who need nursing care may be accommodated. Within the maximum number of 33, up to 6 service users in category of PD(E) (physical disablity) aged 65 years and over may be accommodated. 2. The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection 25th January 2005 Brief Description of the Service: The Hill is a care home registered to provide both nursing and personal care for adults who have a physical disability. The home is situated approximately one mile from Sandbach town centre and is set in its own extensive grounds.Resid nts are accommodated on the ground and the first floor. Access to first floor is via passenger lift or staircase. Residents accommodation comprises thirty-four single bedrooms, one of which has an en-suite facility. There are two lounges, a dining room and an occupational therapy room. The Hill F51 F01 S18792 The Hill V234981 290705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit of the home took place over seven hours and was carried out as part of the yearly inspection process. A tour of the home was carried out and care records, fire records, staff training files and duty rotas were inspected. The service history of the home and the previous inspection report were read in preparation for the inspection. Seven of the staff on duty, ten residents and four relatives were spoken with during the inspection. What the service does well: The bedrooms at the Hill are well personalised with residents’ own items such as televisions, computers and play-stations. One resident has a small pet and residents enjoyed watching the puppy that the activities organiser brings in to the home. Residents say that they are involved and consulted regarding their daily routines and can make choices as to where they spend their day. Some care plans had been signed by residents and personal profiles had been completed by residents or their families. Residents said that they were happy with the activities on offer at The Hill. Staff were friendly and attentive to the residents and had a good knowledge of the residents needs and the character and history of the residents in their care. The home manager is experienced and competent. The home was clean and free from any unpleasant odours. The Hill F51 F01 S18792 The Hill V234981 290705 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? 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 Hill F51 F01 S18792 The Hill V234981 290705 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection The Hill F51 F01 S18792 The Hill V234981 290705 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,4 Although staff spoken with were aware of some of the needs of residents there was no recorded evidence to support that the needs of residents admitted for respite care to the home can be met. EVIDENCE: Since the last inspection the statement of purpose has been updated to ensure that prospective residents and their families have the correct information to enable them to make an informed choice regarding whether they would like to live at The Hill. Two newly admitted residents had been transferred from hospital and there was supporting documentation from the nursing staff. One resident spoken with said that he had visited the home prior to his admission but there was no documentary evidence to support this. One resident that had been admitted for respite care had no pre-admission documentation in place. (See requirement 1) The staff members on duty were spoken with and they were aware of some, but not all, of the needs of the residents that had been admitted. The Hill F51 F01 S18792 The Hill V234981 290705 Stage 4.doc Version 1.30 Page 9 The Hill does not provide intermediate care. The Hill F51 F01 S18792 The Hill V234981 290705 Stage 4.doc Version 1.30 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,9 New care planning documentation is being introduced but the home cannot identify the changing needs of the residents living there. Resident living at The Hill can make choices about how they spend their days. Risk assessments are in place to enable the residents to maintain an independent lifestyle. EVIDENCE: Care plans were examined, two that had been completed using the recently improved style of plans and two that were on the old documentation. These plans had detailed assessments of areas of need, such as mobility, falls, moving & handling, continence, pressure area & tissue viability, nutrition and general dependency. A record was also made of support from and visits by other health professionals such as GP’s, Occupational Therapists and Physiotherapists. A care plan in place for diabetes for one of the residents stated that blood sugar monitoring should take place weekly, however, there were two recording charts running concurrently and it was unclear as to how often the blood sugars were being monitored. (See requirement 2) The Hill F51 F01 S18792 The Hill V234981 290705 Stage 4.doc Version 1.30 Page 11 This resident had a Waterlow score( a measurement tool to assess skin integrity) that was scored as high but had no care plan in place to address his needs with regard to skin integrity. (See requirement 2) Risk assessments were in place for bathing, use of wheelchair, travelling in mini-bus and smoking. Some of these had been signed by the residents. A resident that had been admitted for respite care had no up to date care plans in place and therefore the resident was at risk of not having their health care needs met. (See requirement 2) The new care plan format is more concise and easier to use than the existing documentation. When the remaining care plans are completed using the new paperwork staff said that they feel that the needs of residents will be fully identified. Residents spoken with said that they could make choices about how they spent their days. One said “ they could get up more or less when they pleased and go to bed as late as they wanted to.” One resident was in their room listening to music and said “that was what he liked to do”. He said that he had been taken out to a market to buy more CDs and went out regularly with the activities organiser. The Hill F51 F01 S18792 The Hill V234981 290705 Stage 4.doc Version 1.30 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,17 Residents are offered a variety of activities that they can join in if they wish. The standard of food supplied at The Hill is good but lacks variety. EVIDENCE: An activities co-ordinator is employed to work at the home. Activities on offer include breakfast club, shopping trips, pub lunches, coffee and crosswords, video club, quiz nights and computers. There is an occupational therapy and physiotherapy room. Residents spoken with said that they liked the activities on offer and that discussion took place with them as to what they would like to do. One resident said they liked going out in the minibus. Another resident said that They“ liked to play on their play-station. One resident had a pet chinchilla and a number of residents said that the activities organiser had a puppy that he had brought in and ”It was fun to watch him play” The Hill F51 F01 S18792 The Hill V234981 290705 Stage 4.doc Version 1.30 Page 13 Most residents said that the standard of food was good but a number said that there was too much chicken. On looking at the menu chicken was offered every day as an alternative. (See requirement 3) The Hill F51 F01 S18792 The Hill V234981 290705 Stage 4.doc Version 1.30 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19 Residents at the Hill receive care and support. EVIDENCE: Residents said that they receive personal care within the privacy of their own bedrooms and that they are aware of who their key-workers are. One resident was arranging a hospital appointment with the assistance of a staff member and said ” he felt he had some control over his life within his physical limitations.” Care plans contained a moving and handling assessment, which identified what equipment, if any, was to be used and how many staff were needed to move the resident. Adequate equipment, such as special chairs and mattresses are in place for any residents that are identified as being at risk of pressure sores. The Hill F51 F01 S18792 The Hill V234981 290705 Stage 4.doc Version 1.30 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 Complaints at the home are dealt with in accordance with the company’s complaints policy and residents and relatives know who to raise concerns with. EVIDENCE: Complaints recorded at the home have been dealt with under the company’s complaint procedure. A copy of the complaints procedure is available in the service users guide. Residents and relatives spoken with said that they had no complaints and that they were aware of whom to speak to if they were unhappy about any aspects of the home. Residents’ meetings take place on a regular basis and residents spoken with felt that their views were listened to. The Hill F51 F01 S18792 The Hill V234981 290705 Stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,26,29,30 Some areas of the home require attention to ensure that residents live in a safe and well-maintained environment. Independence of the residents is promoted and supported at The Hill. The home is clean and free from unpleasant smells. EVIDENCE: One bedroom has been redecorated since the last inspection. The care manager said that the carpet in the upstairs corridor had been deep cleaned as required in the last inspection but this has not removed the stains. This carpet should be replaced. (See requirement 4) Some bedrooms are in need of redecoration as the paintwork was scuffed in front of the vanity units. A requirement was made regarding these areas at the last inspection. There have been discussions for some time regarding a new home that is to be built on the site of The Hill, the date of this has not yet been agreed. Residents and relatives spoken with said that “they feel the home looks tired and is in need of sorting out “ they said that “ no date has been set The Hill F51 F01 S18792 The Hill V234981 290705 Stage 4.doc Version 1.30 Page 17 to start work and the home looks shoddy especially within our bedrooms” “we get fed up asking for things to be done” (See requirement 5) The care manager said that a quote had been obtained for the deep cleaning of the carpets in the downstairs corridor and this was to take place within the next few weeks. The home has its own occupational therapy and physiotherapy staff and any necessary adaptations are made following individual assessment. Specialist equipment is available at The Hill to maximise the independence of the residents living there. The Hill F51 F01 S18792 The Hill V234981 290705 Stage 4.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,35 The numbers of staff on duty are inadequate to meet the needs of the residents living at The Hill. Resident’s benefit from a service that provides well-informed and knowledgeable staff. EVIDENCE: Staff spoken with said that their morale was low at the present time as a number of staff that had been at the home for some time had retired. New staff had been employed but the induction of these staff members was time consuming. They said that they were working short staffed on a number of days each week. Duty rotas were seen and the staffing numbers at the home a were below the required minimum staffing levels on some occasions each week ( See requirement 6 ) The staff confirmed that they had received training in adult protection, Moving & Handling, fire, first aid, infection control Diabetes care, tissue viability, nutritional support and NVQ in care. They felt that they had a good understanding of the needs of the residents in their care and had a good relationship with them. The residents living at the home confirmed that staff were aware of their needs. The Hill F51 F01 S18792 The Hill V234981 290705 Stage 4.doc Version 1.30 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 The management of the home maintains the safety of the residents living there. EVIDENCE: Care plans that had been completed correctly had residents’ choices recorded. The proprietor or his designated representative visit the home on a monthly basis, unannounced, to check on health and safety, property and equipment and staffing issues. Discussion with residents, relatives and staff take place during these visits. A copy of the report produced is sent to CSCI Safety certificates were in place for items of equipment such as hoists and passenger lifts. The fire log was checked and staff training has taken place in May 2005 and has been recorded. Emergency lighting was being checked and recorded appropriately. It was unclear due to the recording system if fire alarms were being checked. ( See requirement 7) The Hill F51 F01 S18792 The Hill V234981 290705 Stage 4.doc Version 1.30 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 2 x 2 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 2 3 x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x x x 2 Standard No 31 32 33 34 35 36 Score x x 1 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Hill Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x x x x x 2 x F51 F01 S18792 The Hill V234981 290705 Stage 4.doc Version 1.30 Page 21 yes 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 YA3 Regulation 14 Requirement All residents admitted to the home must be assessed including residents admitted for respite stays. Residents must have an up to date care plan in place which adequatly reflects their changing needs Adequate food choices must be offered to residents The carpet in the upstairs corridor must be replaced Residents bedrooms must be assessed and approprate remedial work must be undertaken. The home must provide adequate numbers of staff to meet the agreed minimum staffing requirements Adequate testing and recording of fire alarms must be undertaken Timescale for action 6th September 2005 6th September 2005 6th September 2005 6th October 2005 6th October 3005 6th September 2005 6th September 2005 2. YA 6 15 3. 4. 5. YA 17 YA 24 YA 24 16 23 23 6. Ya33 18 7. YA 42 23 The Hill F51 F01 S18792 The Hill V234981 290705 Stage 4.doc Version 1.30 Page 22 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 Good Practice Recommendations The Hill F51 F01 S18792 The Hill V234981 290705 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection 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 The Hill F51 F01 S18792 The Hill V234981 290705 Stage 4.doc Version 1.30 Page 24 - 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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