Inspection on 03/03/06 for Hill House

This inspection was carried out on 3rd March 2006.

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 5 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 29/07/05

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 Inspection 3rd March 2006 09:00 The Hill DS0000018792.V282204.R01.S.doc Version 5.1 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 The Hill DS0000018792.V282204.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 Adults 18-65. 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. The Hill DS0000018792.V282204.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Hill Address Newcastle Road Sandbach Cheshire CW11 1LA 01270 762341 01270 527414 hill@wwm.leonard-cheshire.org.uk 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) Leonard Cheshire Mrs Jean Parry Care Home 33 Category(ies) of Physical disability (33), Physical disability over registration, with number 65 years of age (6) of places The Hill DS0000018792.V282204.R01.S.doc Version 5.1 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 the 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 the category of PD(E) (physical disability) aged 65 years and over may be accommodated The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection 29th July 2005 2. Date of last inspection 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 Residents 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 DS0000018792.V282204.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit of the home took place over five hours and was carried out as part of the yearly inspection process by two inspectors. A tour of the home was carried out and care records, fire records and duty rotas were inspected. The service history of the home and the previous inspection report were read in preparation for the inspection. Staffs on duty, ten residents and four relatives were spoken with during the inspection. What the service does well: What has improved since the last inspection? The care plans at the home have been improved and contain adequate information to enable staff working at the home to care for the residents. The number of staff on duty on each shift is within the required agreed staffing levels. The menus have been improved to offer more choice for the residents living at the Hill The Hill DS0000018792.V282204.R01.S.doc Version 5.1 Page 6 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 DS0000018792.V282204.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection The Hill DS0000018792.V282204.R01.S.doc Version 5.1 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 the following standard(s): 2 Residents within this service have a wide range of needs assessed at the point of admission; there is however an absence of a nutritional assessment being undertaken for those residents admitted for personal care only. EVIDENCE: At this inspection the care records of five residents were looked at. Three were identified as requiring nursing care and two personal care. Each person had a comprehensive initial assessment, which was used to develop a specific care plan. There was however, no evidence of a nutritional assessment having been carried out for either of the two residents in receipt of personal care. When this was brought to the attention of the two nurses on duty, their response was, residents requiring nursing care were assessed in this area as a matter of course, but not those identified as needing personal care. The Hill DS0000018792.V282204.R01.S.doc Version 5.1 Page 9 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 the following standard(s): 6,7,8,9 Residents are actively involved in creating and reviewing their care plans. They also make choices about daily routines and leisure activities. Residents are aware of planned changes to the home and the development of an improved service. EVIDENCE: The care file of five residents were looked at and ten residents were spoken with. Care files contained specific care plans based upon comprehensive assessments; these were periodically reviewed and signed by residents. Each resident had been assessed for specific areas of risk and appropriate measures were in place to minimise or remove these risks. Care plans had been reviewed and up-dated as appropriate. Residents spoken with were aware of the organisations plans to redevelop the site with a new building and commented that they were being kept up-to-date on the planned worked. There is a resident’s committee that provides a focus for resident’s comments and concerns to be aired. The Hill DS0000018792.V282204.R01.S.doc Version 5.1 Page 10 Residents said that they had opportunities to “be involved in the practical running of the home.” and were “able to get out either by themselves or more often with staff support”. One resident spoke about his plans to visit London by train the near future and how staff were supporting him in this activity. The Hill DS0000018792.V282204.R01.S.doc Version 5.1 Page 11 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 the following standard(s): 13,15,16,17. Residents living at The Hill feel part of the local community and can go out with support as they wish. Menus at the home have been improved to give more variation. EVIDENCE: The home is close to Sandbach town centre and a short ride to Crewe. Residents said that they enjoy going to the local pubs, leisure centres and shops. Transport is available at the home or through community or private hire. The home has international volunteers who can accompany residents when they go out. Residents spoken with said that they were “able to get out either by themselves or more often with staff support”. One resident spoke about his plans to visit London by train the near future and how staff were supporting him in this activity. The home has an open visiting policy and relatives spoken with said they could visit at any time. The Hill DS0000018792.V282204.R01.S.doc Version 5.1 Page 12 Life-long learning is encouraged and the home has its own computer suite. Occupational therapists and physiotherapists are involved in the assessment of residents living at the Hill. At the last inspection residents said that although the food was good the menus at the home needed to be more varied. This requirement has been addressed and the residents said that these had improved. The Hill DS0000018792.V282204.R01.S.doc Version 5.1 Page 13 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 the following standard(s): 18,19,20 The residents at The Hill are provided with a good care and support Medication is not being properly managed to ensure the safety of the residents living at The Hill. EVIDENCE: The individual care records reviewed contained details of contact with GPs, Consultant Physicians, Dental services, Opticians, Chiropodists and Social Workers from the community. Staff from within the service provides OT and Physiotherapy services. Residents stated that “ staff are good” “considerate” and “do a good job” Medication recording, management and storage were looked at. Medicine Administration Records were examined and there were some unexplained gaps in the recording of medications. It was found that the medication of two residents had not been taken out of the blister packs but these had been recorded as given. The Hill DS0000018792.V282204.R01.S.doc Version 5.1 Page 14 It is recommended that residents taking analgesia have the number of tablets given recorded (i.e. one or two tablets,) so that staff are aware how many tablets have been given to the resident in a twenty four hour period. Medicines were stored and disposed of appropriately. The Hill DS0000018792.V282204.R01.S.doc Version 5.1 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 the following standard(s): EVIDENCE: The key standards were assessed and met at the last inspection. The Hill DS0000018792.V282204.R01.S.doc Version 5.1 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 the following standard(s): 24 Some areas of the home require attention to ensure that residents live in a safe and well-maintained environment. EVIDENCE: The requirements from the last inspection regarding the environment have not been met and will be repeated. The carpet in the upstairs corridor is stained and should be replaced as required in the last inspection. The downstairs corridor carpet is stained and requires replacing. 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 two inspections. 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. The Hill DS0000018792.V282204.R01.S.doc Version 5.1 Page 17 Residents and relatives spoken with said, “The home looks scruffy and needs a coat of paint.” “ I wish they would sort this place out or start the new one” “ The new building is a long time coming” “ we are sick of waiting for things to be done” The regional manager for The Hill was at the home during the inspection and agreed that some monies will be released by the company to improve the environment for the residents. The Hill DS0000018792.V282204.R01.S.doc Version 5.1 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32. The numbers of staff on duty are adequate to meet the needs of the residents living at The Hill. Training is taking place but the numbers of staff qualified in NVQ level two is unclear. EVIDENCE: Duty rotas were seen and the agreed staffing numbers at the home were being met. The staff confirmed that they had received training in NVQ in care. The manager was asked how many care staff were qualified in NVQ level two but she was unable to provide this information on the day of inspection. The information sent to CSCI was unclear as to the numbers of staff qualified. The Hill DS0000018792.V282204.R01.S.doc Version 5.1 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,42 Some areas of management of the home need to be improved to maintain the safety of residents and staff. EVIDENCE: Residents living at the Hill feel they are involved in the running of the home. Care plans have improved and residents’ choices are recorded. The fire log was checked and staff training has taken place in October 2005 and has been recorded. Fire alarms were being checked and recorded appropriately. There was no recorded evidence that emergency lighting was being checked. The Hill DS0000018792.V282204.R01.S.doc Version 5.1 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 Standard No Score 1 X 2 2 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 x 23 x ENVIRONMENT Standard No Score 24 1 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 3 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 X X X X 2 x The Hill DS0000018792.V282204.R01.S.doc Version 5.1 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. 2. Standard YA20 YA24 Regulation 13 23 Requirement Medication issues identified in the report must be addressed. The carpet in the upstairs corridor must be replaced (previous timescale of 6/10/05 not met) The carpet in the downstairs corridor must be replaced. Residents bedrooms must be assessed and approprate remedial work must be undertaken. (previous timescale of 6/10/05 not met) The emergency lights in the home must be tested and recorded on a regular basis. Timescale for action 21/04/06 31/04/06 3. 4 YA24 YA23 23 23 31/04/06 31/04/06 5 YA42 23 21/04/06 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 YA2 Good Practice Recommendations It is recommended that all residents admitted to the home have a nutritional assessment in place. DS0000018792.V282204.R01.S.doc Version 5.1 Page 22 The Hill 2 YA32 The home must have 5o of care staff qualified to NVQ level 2 or equivalent. The Hill DS0000018792.V282204.R01.S.doc Version 5.1 Page 23 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. 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