Inspection on 09/05/06 for The Hillings

This inspection was carried out on 9th May 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 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

The Hillings 15/10/09

The Hillings 16/01/09

The Hillings 02/11/07

The Hillings 23/05/06

The Hillings 22/09/05

The Hillings 13/05/05

The Hillings 05/10/04

The Hillings 16/06/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE The Hillings Grenville Way Eaton Socon Cambridgeshire PE19 8HZ Lead Inspector Joanne Pawson Unannounced Inspection 9th May 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Hillings DS0000015140.V291918.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Hillings DS0000015140.V291918.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Hillings Address Grenville Way Eaton Socon Cambridgeshire PE19 8HZ 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) 01480 214020 01480 475755 The Hillings Limited Margaret Rose Fuggles Care Home 46 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (46) of places The Hillings DS0000015140.V291918.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd September 2005 Brief Description of the Service: The Hillings is registered to provide accommodation and support for 46 people over 65 years of age (20 of whom may have dementia). The home offers single storey accommodation in five units each comprising of single bedrooms, a lounge/dining room, kitchen, toilets and bathroom. There is also a main kitchen, a laundry, staff facilities and sluices. 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 and is used as an activity centre. The home is situated at the end of a cul-desac 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 current fees for privately funded resident’s range from £525 to £600 a week depending on the level of care provided and if the bedroom has an ensuite toilet and funded residents fees range from £351 to £416. The Hillings DS0000015140.V291918.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on the 9th May 2006 for seven hours and was conducted by one inspector and one regulation manager. Methods used for the inspection included speaking to the manager, staff and residents, reading documentation, a review of information received since the last inspection and a tour of the home. On the day of the inspection there were 46 residents living in the home. Some requirements from the last inspection have not been met. What the service does well: What has improved since the last inspection? The general atmosphere in the home has improved since the last inspection. The staff team were much more relaxed and the manager has more freedom to manage the home since the new owners bought the home. Care plans are being reviewed on a more regular basis and are being signed by the resident. During a complaint investigation to the home last August it was found that there were communication difficulties between the overseas staff and the The Hillings DS0000015140.V291918.R01.S.doc Version 5.1 Page 6 residents and other staff. The overseas staff have been attending English speaking lessons to improve their communication skills. 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 Hillings DS0000015140.V291918.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Hillings DS0000015140.V291918.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3, Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Prospective service users needs are assessed before moving into the home to ensure the home can meet their needs. EVIDENCE: Some of the residents tracked had not had a visit from a representative from the home but had their needs assessed by a care manager who had then passed on the information to the home. One of the initial assessments was not dated or signed by the person completing the form. Two statements of purposes were seen in a resident’s bedroom although it was not up to date. The manager stated that it had been up dated and wasn’t aware of why there were old copies in the residents room and would ensure all residents have a current copy. A resident’s relative stated that the manager had provided her with a copy of the latest inspection report when her relative moved into the home. Intermediate care is not provided in this home. The Hillings DS0000015140.V291918.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The care plans seen contained the information about the residents needs however not all of the care plans were up to date and this could lead to residents needs not being met. EVIDENCE: There is a lot of information in the care plans, some of it is repeated. The manager stated that there will be a new format for care plans to streamline them. Two of the three care plans tracked had been reviewed regularly however one of the care plans tracked had not been reviewed in 2006. Care plans must be reviewed regularly and updated to ensure the residents are receiving the appropriate care. Evidence was seen that carers are reminded in care plans to encourage residents to be as independent as possible. One care plans stated ‘allow him to do what he can and seek permission to help with his care’. The Hillings DS0000015140.V291918.R01.S.doc Version 5.1 Page 10 The medication administration sheets were inspected. There was an omission of a signature for one resident’s medication however the medication was not in the blister pack. Staff must ensure they sign to say if medication has been administered. A requirement has been made that staff must accurately administer and record medication. Medication for one resident was audited and the number of signatures did not reflect the number of tablets left in the pack. A medication administration sheet dated October 2005 was found on a wall in one service users ensuite toilet for the application of a cream. The staff on duty were not aware of why the sheet was still on the wall and stated that it was a medication that was only given when required. Residents spoken to said they were happy with the care they received and all their needs were met. Residents also stated that staff respect their privacy for example they always knock on their bedroom door before entering. The Hillings DS0000015140.V291918.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There are varied activities available for those who want to join in group activities or continue with their own hobbies and interests. EVIDENCE: There is a full time activities coordinator. A group of residents spoken to stated that they really enjoyed going to the ‘link room’ where they do various craft activities. They also stated that they really enjoyed putting a pantomime on at Christmas for the other residents. One resident stated that she enjoys knitting squares to make blankets and when she had used all of her wool a member of staff brought some in for her. On the day of the inspection there was an entertainer playing a keyboard and singing. The residents were evidently enjoying it and joining in with the songs. The main meal on the day of the inspection was liver and onion or minced beef and vegetables in gravy with mashed potato and runner beans. The residents stated that the food was ‘o.k.’ but the quality varied from day to day. The manager stated that the menu had recently been changed to offer more choice. The resident’s meeting minutes stated that there was now more choice in the evening. Residents with dementia were observed being assisted to eat. When the residents did not understand the choice offered the care staff made the The Hillings DS0000015140.V291918.R01.S.doc Version 5.1 Page 12 decision. It would have been possible to show the residents the plates of food with the different choices on as this may of helped them to make a decision. It was also observed that more than one resident was assisted to eat by the same member of staff at the same time, this resulted in the member of staff helping one resident and then going across the room to help the other resident and then back again. Mealtimes should be unrushed and a time for staff to interact with residents. The staff member responsible stated that it would be beneficial to have more staff on shift at meal times. The manager stated that if she is not busy at lunchtimes then she helps with the residents that need assistance but that it is not always possible for her to do that. Consideration must be given to making the mealtimes more of a relaxed time by providing more staff cover or staggering the meal time so that staff can spend one to one time with the residents that need assistance. A relative of a resident who had recently moved into the home stated that the care staff had been very supportive and sensitive when she was worried about leaving her relative and they had told her to ‘think of it as where he just sleeps’. Residents can see relatives in the communal areas of the home or in their bedrooms. The contact details of Age Concern are available on the notice board in the foyer of the home. The Hillings DS0000015140.V291918.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff are aware of the procedures to be followed if they suspect a resident has been abused. This should help to protect the residents from abuse. EVIDENCE: The complaints procedure was seen displayed throughout the home. Residents spoken to said that they would speak to a member of staff if they wanted to complain. One complaint has been received since the last inspection. The commission made six recommendations to the home as a result of the complaint investigation. Three staff files were tracked. It was clear that one of these members of staff had received training in the protection of vulnerable . The manager stated that one of the files tracked was for a new member of staff and she was waiting for them to bring in their certificates. The care staff on shift were aware of the correct procedure to be followed if they thought a resident has suffered any kind of abuse. The Hillings DS0000015140.V291918.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment of the home provides residents with an attractive and homely place to live, with the equipment they need to help promote their independence. EVIDENCE: The majority of the home is well maintained, free from offensive odours and clean. Residents commented on how nice it was to have vases of fresh flowers in one of the flats. There are various craft pictures and photographs of the residents throughout the home. This helps to give a homely appearance. The bath in Flat B has a broken side panel and looks worn and a hole in the wall above the bath. The toilet seat was broken but was fixed during the inspection. One of the bathrooms had no curtains or blinds and looked very clinical and uninviting. The Hillings DS0000015140.V291918.R01.S.doc Version 5.1 Page 15 One bedroom carpet was stained and worn and in need of replacement. There are accessible toilets for residents close to the communal areas and their bedrooms. Procedures are in place for infection control. An alcohol hand lotion is available at the entry of each flat. Parts of the grounds are overgrown. The manager stated that work had started on the grounds. Twenty of the 48 places provided by the home can be residents with dementia. Although the flats which provide care for the residents with dementia are pleasant there does not seem to have been consideration in line with current guidance about providing a stimulating environment and helpful visual aids. Residents stated that they were encouraged to bring in their personal possessions to decorate their room. The Hillings DS0000015140.V291918.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Staff are not receiving the mandatory training necessary to ensure they can meet the residents needs. EVIDENCE: Three staff files were tracked and contained the necessary recruitment information i.e. application form, two references and criminal records bureau checks. However it was difficult for two of the staff members tracked to see if they had completed all of the mandatory training required. The manager agreed to complete a list of all staff and the training they have completed and sent it to the inspector within two weeks of the inspection. Completion of mandatory training was a requirement from the last inspection. Failure to meet this requirement may lead to the commission taking enforcement action. The manager stated that a new company were going to be responsible for providing all of the staff training but that no dates of courses had yet been made available. Staff must complete mandatory training to ensure the residents safety. Six members of the care staff have an NVQ in Care, a further four are currently working towards it. There are eight care staff on duty from 8am until 10pm. All of the residents asked on the day of the inspection said that they thought there were enough staff on duty. Staff observed during the day were seen to treat residents with dignity and respect. The Hillings DS0000015140.V291918.R01.S.doc Version 5.1 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,36,38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is run in the best interests of the residents. EVIDENCE: The manager has been registered with the commission since April 2004. During the registration process she agreed to complete the NVQ 4 in management and care and a course in dementia. The manager stated she is about half way through the NVQ but has not completed any dementia training yet. It was agreed at the inspection that as the home has a high percentage of residents with dementia then the manager should still complete a course in dementia care. The Hillings DS0000015140.V291918.R01.S.doc Version 5.1 Page 18 Whilst the provider has completed visits to the home copies of the management visit forms (Regulation 26 of the Care Homes Regulations) have not been sent to the Commission since August 2006. The man Staff stated that they would talk to one of the managers if they had any concerns. The minutes of the most recent residents meeting stated ‘the meetings are for residents to have their say, and they shouldn’t be afraid to speak up if they have any issues. The manager also sends out satisfaction questionnaires to residents or their relatives and any visiting health professionals. If the replies raise any issues the manager then takes the appropriate action and writes to the complainant. The testing of the fire alarm records were inspected. Although they have been tested regularly they had not been tested in the week previous to the inspection. A fire exit in one of the flats was blocked by a vacuum cleaner for a considerable amount of time during the inspection. Secure facilities are provided for the safe keeping of resident’s money and valuables. The Hillings DS0000015140.V291918.R01.S.doc Version 5.1 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 2 3 3 2 3 3 STAFFING Standard No Score 27 1 28 2 29 3 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 3 3 3 2 2 The Hillings DS0000015140.V291918.R01.S.doc Version 5.1 Page 20 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 OP1 Regulation 4 Requirement An updated copy of the statement of purpose must be given to the service users and the Commission. Each service user must have a written plan that is accurate and up to date and includes all information on how a service users health and welfare needs are to met. The care plan should be signed by service users or their representative to say they have read it. This was a requirement from the previous inspection. This was a requirement from the previous inspection. Failure to meet this requirement may lead to the commission taking enforcement action. The manager must ensure the accurate administration and recording of medication. Keep the bathroom in a good state of repair. Replace worn carpets in service users bedrooms as necessary. The registered person shall DS0000015140.V291918.R01.S.doc Timescale for action 01/07/06 2. OP7 15 01/08/06 3. 4 5 6. OP9 OP21 OP24 OP27 13(2) 23(2)(b) 23(2)(b) 18(1)(a) 01/06/06 01/07/06 01/07/06 01/07/06 Page 21 The Hillings Version 5.1 ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and safety of service users. This includes ensuring there are enough staff to help residents at mealtimes. 7. OP30 18(1)(C )(i) All staff should receive mandatory training on a regular basis to include fire, moving and handling, health and safety, food hygiene, medication (for those responsible) and first aid. This was a requirement from the previous inspection. Failure to meet this requirement may lead to the commission taking enforcement action. Ensure all fire exits are clear at all times. 01/09/06 8 OP38 23(4)(a) 15/05/06 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 2 Refer to Standard OP28 OP31 Good Practice Recommendations A minimum ration of 50 NVQ 2 in Care qualified staff. The registered manager should complete the NVQ 4 in care and management (or equivalent) and a course in dementia care. The Hillings DS0000015140.V291918.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB1 5XE 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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