Inspection on 15/10/09 for The Hillings

This inspection was carried out on 15th October 2009.

CQC found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Hillings 16/01/09

The Hillings 02/11/07

The Hillings 23/05/06

The Hillings 09/05/06

The Hillings 22/09/05

The Hillings 13/05/05

The Hillings 05/10/04

The Hillings 16/06/04

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Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

Key inspection report Care homes for older people Name: Address: The Hillings Grenville Way Eaton Socon Cambridgeshire PE19 8HZ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Joanne Pawson     Date: 1 5 1 0 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 22 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 22 Information about the care home Name of care home: Address: The Hillings Grenville Way Eaton Socon Cambridgeshire PE19 8HZ 01480214020 01480475755 admin@thehillings.healthcarehomes.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): The Hillings Limited Name of registered manager (if applicable) Mr Matthew Brian Cox Type of registration: Number of places registered: care home 64 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home The Hillings is situated at the end of a cul-de-sac in a quiet residential area of Eaton Socon a few minutes walk from local shops and about two miles from the busy market town of St Neots. The Hillings is registered to provide accommodation and support for 64 people. The home offers single storey accommodation in five flats each comprising of single bedrooms, a lounge/dining room, kitchen, toilets and bathroom. Two of the units are for people who need extra care due to dementia (up to twenty residents) and there are several respite care places. A large conservatory links the two extra care units, which is also used as an activity centre. There is a main kitchen, laundry, staff facilities and sluices. The weekly fees range from £378.90 to £645. The CQC report is made available in the foyer of the home. Care Homes for Older People Page 4 of 22 Over 65 0 54 30 0 1 6 0 1 2 0 0 9 Brief description of the care home Care Homes for Older People Page 5 of 22 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We carried out a key inspection of The Hillings on the 15th October 2009 at 10:00am using the Commissions methodology described below. This report makes judgements about the service based on the evidence we gathered. We spoke with the people who live at the home, the staff and the manager as part of the inspection. We also looked at documents including care plans, medication administration records and health and safety records. Care Homes for Older People Page 6 of 22 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 7 of 22 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 22 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information is provided in a variety of ways so that people who are thinking about moving into the home can make a decision as to whether their needs can be met. Evidence: The service user guide and statement of purpose are available in different formats (large print and audio). The service user guide and statement of purpose were good at a previous inspection and have not been inspected again. The pre-admission assessments show that people who have expressed an interest in moving into the home are assessed to make sure that the home can meet their needs. Care Homes for Older People Page 9 of 22 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The recording of the administration of medication must improve to ensure that the residents receive their medication as prescribed. Evidence: We looked at the care plans for three residents. They contained detailed information about how the residents needs should be met and were written in a person centred way. The first care plan we looked at had information for the staff about the residents medical condition and how this may affect him. There was very descriptive information from a residents relative about what he should eat and when but when we asked the manager if staff felt they had to follow this rather than give the resident choices he confirmed that although they had the information the resident was always given a choice. Part of the care plan was about how the resident could be helped to make choices. Another part of the care plan was about how the staff can help the resident to feel safe. The daily notes for one resident showed that he was treated with respect and supported when he was feeling in a low mood a member of staff had held his hand until he fell asleep. The care plan for another resident contained detailed information about how the staff could keep her safe. Care plans are reviewed monthly. Care Homes for Older People Page 10 of 22 Evidence: The records showed that the residents are receiving access to regular health checks as necessary. One resident told us that he receives the right level of support from the staff with his personal care. We looked at the medication administration records and the stocks of medication for several residents. The records for the applications of creams and lotions are kept in the same cabinets as the care plans on the flats. When we looked at the records for each person there were repeated omissions for signing for the application of creams. When we told the manager our findings he told us that he was disappointed as the records had been put with the care plans so that the carers could complete them after they had applied the cream. We asked one carer if she had applied any cream to a resident that morning and she told us she had but that she had not yet signed to say she had administered it but was going to do it at the end of her shift. When we looked at the stock and records for the administration of medication in the medication room we found more inconsistencies. For five of the peoples records we looked at we found that the levels of stock did not reflect the records. The keys for the controlled drugs cupboard were not securely stored. The manager told us that he had been advised by the supplying pharmacy that it was appropriate to store the keys in this way. However if someone gained entrance to the medication room they would have access to the controlled drugs cupboard which means the controlled drugs are not stored anymore securely than the other medication in the home. We left an immediate requirement with the manager that there must be a stock audit of all the medication and that there must be accurate administration and recording of all medication. We observed a group of residents in one lounge sitting and talking to the daily activities organiser. They seemed to be really enjoying his company and he spoke to them about things they were interested in such as planes and what was in the news. Another member of staff showed respect and warmth in the way that he talked with the residents. One resident was interested in the domestics tattoos so he turned off the vacuum cleaner and spoke to her about them. When one member of staff had to leave a resident she explained that she had to go and would be back later. There was lots of laughing from both the residents and the staff. We received seven surveys from the residents. Care Homes for Older People Page 11 of 22 Evidence: All seven stated that they always or usually receive the care and support they need. One resident stated very good care and the people are friendly. Care Homes for Older People Page 12 of 22 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents are treated as individuals and are supported to make choices according to their likes and dislikes. Evidence: Several residents and staff were seen sitting at a table discussing what was in the newspaper and other subjects of interest. The staff seemed to know the residents well and talked about things that would interest them. There was lots of laughing and joking with the staff and residents. On another flat we saw lots of equipment for activities but none were being used whilst we were there. One of the members of staff did tell us the residents had been using it in the morning. We observed lunchtime. All of the residents were offered a choice of drink and had pre- ordered their meal. Residents were also asked if they would like salt and pepper on their meal and how much.One member of staff was seen encouraging a resident to eat their meal in a calm and caring manner. A birthday cake had been baked and decorated for one resident. Care Homes for Older People Page 13 of 22 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints are taken seriously and dealt with appropriately. Evidence: We looked at the complaints which had been received since the previous inspection. Five official complaints had been recorded. The manager had investigated the complaints and taken any appropriate action including replying to the complainant. Of the seven surveys returned from the residents six of them stated that there is someone they can speak to informally if they are not happy but only three of them knew how to make a formal complaint. Care Homes for Older People Page 14 of 22 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager has worked hard to provide a stimulating environment for the residents to live in. Evidence: The home was clean and well maintained on the day of the inspection. There were no unpleasant odours. Residents are encouraged to personalise their bedrooms. Pictures, mirrors and items of interest for residents to touch have been put on the walls. The manager told us that an area where the residents use to bang on the door and ask to go out had been made a into a quiet area with a comfortable chair and books and magazines to look at and that the residents no longer became agitated in this area. Bathroom and toilet signs with words and pictures have been put on the doors to make it easier for the residents to find their way around. Care Homes for Older People Page 15 of 22 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff have the training they require to meet the residents needs. Evidence: We cased tracked four members of staff. We looked at their recruitment documents and found them to be satisfactory. One member of staff was working on a student visa and the manager was unsure legally how many hours the carer could work in the home. The manager looked into this during the inspection and the carer was not exceeding the hours but the manager must make sure that he is aware of any restrictions before employing staff. The staffing levels on the day of the inspection seemed to be sufficient. The residents we spoke to told us that they did not have to wait too long when they needed any assistance. We also looked at the training records for the members of staff that we cased tracked and all of their mandatory training was up to date. The manager also told us about a special team of staff he was putting together to undertake training about working with people with dementia. The staff would then use their training when working with the residents and pass on the information to other staff. Care Homes for Older People Page 16 of 22 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is run in an open and transparent way with the residents wishes taken into consideration. Evidence: The majority of staff spoken to on the day of the inspection stated that the manager was supportive. The manager was observed talking with some residents and they seemed to have a good relationship. One resident commented the manager is a smashing bloke, talks to you, always got time for you. Staff receive regular supervision with a manager. Regular meetings are held so that the residents can get together and discuss any issues in the home or anything they would like done differently. Fire records were seen and staff have been involved in fire drills although it was not clear which staff had been present. Other fire checks such as fire alarms and emergency lighting have been completed as required. The money and records of some of the residents were checked and found to be Care Homes for Older People Page 17 of 22 Evidence: accurate. Care Homes for Older People Page 18 of 22 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 19 of 22 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action 1 9 13 A full audit of the stock of medication must be completed. This will ensure that the records of medication accurately reflect the stock levels to ensure the correct administration of medication. 17/11/2009 2 9 13 There must be accurate 17/11/2009 administration and recording of all medication. To ensure that the residents receive the medication that has been prescribed for them. Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 Controlled drugs must be stored securely in compliance with the Misuse of Drugs (Safe Custody) regulations 1973. This will help to ensure that unauthorised persons do not have access to the controlled drugs stored in the home. 11/11/2009 Care Homes for Older People Page 20 of 22 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 21 of 22 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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