Care Home: Hill House Nursing Home

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What the care home does well Residents have regular meetings so that they can say what they think about the service, and how they want things to be done. They are helped to make choices and decisions about things like what they want to eat, what activities they want to do, and where they want to go. They are also given information about what improvements are planned for the home, so that they can be involved and give their opinions. People told us, `I believe the home provides a good caring environment` and `I like all the staff`People can choose to do things like swimming, cooking, horse riding and bowling. There are lots of things for them to do in the home such as art sessions, music and movement and gardening; and they can also help with household chores if they are able to. People spoken with and those returned surveys told us that they were happy living at the home and had access to a variety of leisure activities. The home makes sure that residents are helped to stay healthy, and can see people like doctors, nurses, chiropodists and dentists whenever they need to. Staff are recruited in a safe way so that residents are protected from inappropriate people being employed. They are given training to make sure that they know how to support people in the right way. What has improved since the last inspection? Records and practices regarding the administration of medications have been reviewed and changes made so that they are safer. The upgrading of the environment of the home and the garden areas has continued with improvements that include the refurbishment of the diner/kitchen area. The home has produced information about the services it offers as well as the way it intends to operate in an easy read format making it accessible to more people. What the care home could do better: The content of care plans needs to be more person centred so that it provides comprehensive details about resident`s individual preferences, goals and aspirations for the future. They should also demonstrate that residents have been involved in the planning of their care, if this is not possible the reason should be recorded. Other areas that would benefit from some attention included the following. Some risk assessments need to contain better detail about management strategies for potential risks so that staff have clearer information about how to minimise them. Care plans should contain information about recent legislation that is designed to protect people`s rights and choices. This is so the home can show they have looked at the effects the legislation has on the resident`s lives and planned their care accordingly. All areas of the home should be kept secure if necessary and areas accessible to residents should be clutter free. CARE HOME ADULTS 18-65 Hill House Nursing Home Sand Lane Osgodby Market Rasen Lincolnshire LN8 3TE Lead Inspector Dawn Podmore Unannounced Inspection 30th July 2008 09:30 Hill House Nursing Home DS0000069470.V369162.R01.S.doc Version 5.2 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 Hill House Nursing Home DS0000069470.V369162.R01.S.doc Version 5.2 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. Hill House Nursing Home DS0000069470.V369162.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hill House Nursing Home Address Sand Lane Osgodby Market Rasen Lincolnshire LN8 3TE 01673 843407 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) mandy@unitedhealth.co.uk www.unitedhealth.co.uk United Health Limited Hazel Ashmore Care Home 35 Category(ies) of Learning disability (35) registration, with number of places Hill House Nursing Home DS0000069470.V369162.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered provider may provide the following categories of service only: Care Home with nursing (N) to service users of either gender, whose primary care needs on admission to the home fall within the following category - Learning Disability LD. The maximum number of service users who can be accommodated is 35. 12th September 2007 2. Date of last inspection Brief Description of the Service: Hill House provides nursing and personal care to people over the age of 18 years who have a learning disability. The home is situated in the grounds of an equestrian centre and some of the residents are actively involved in caring for the animals. Within the grounds there is the main house and two separate buildings, which accommodate residents who are able to live more independently. All care records are maintained within the main house. Accommodation is provided on the ground and first floors. The home does not have a lift and residents accessing first floor rooms must be able bodied. At the time of the inspection the deputy manager confirmed that the weekly fees ranged from £390 - £804 depending on the residents assessed needs. Additional charges are made for hairdressing, chiropody, newspapers, toiletries, holidays, public transport, and riding lessons. Information about these costs as well as the day-to-day operation of the home, including a copy of the last inspection report is available at the home. Hill House Nursing Home DS0000069470.V369162.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This key inspection was unannounced and took any previous information held by C.S.C.I. about the home into account. The manager was unavailable, but the deputy manager, Allison Smith, assisted with the inspection process. The main method of inspection used was called case tracking. This involved selecting a proportion of residents and tracking the care they receive through the checking of records, discussions with them and the staff who care for them and observation of care practices. A partial tour of the home was also conducted which included looking at some bedrooms, communal areas, outside areas, bathing and toilet facilities. Documentation was sampled and the care records of four residents were examined. We spoke with residents and staff who shared their views about how the home operated on a day-to-day basis and the care and facilities provided. The Commission are trying to improve the way that we engage with people who use services so that we gain a real understanding of their views and experiences of social care services. During this inspection we used a method of working where an ‘expert by experience’ visited the home as part of the inspection to help us get a picture of what it is like to live in this service. The term ‘Experts by Experience’ used in this report describes people whose knowledge about social care services comes directly from using them. The expert met and talked to people over a 2 hour period and at the end he told the inspector and the deputy manager what he had found. Prior to the visit the providers had returned an Annual Quality Assurance Assessment (AQAA) and this document will be mentioned throughout this report. We sent out some ‘have your say’ surveys, four of which were returned in time for their views to be included in this report. On the day of the visit 25 residents were living at the home. What the service does well: Residents have regular meetings so that they can say what they think about the service, and how they want things to be done. They are helped to make choices and decisions about things like what they want to eat, what activities they want to do, and where they want to go. They are also given information about what improvements are planned for the home, so that they can be involved and give their opinions. People told us, ‘I believe the home provides a good caring environment’ and ‘I like all the staff’ Hill House Nursing Home DS0000069470.V369162.R01.S.doc Version 5.2 Page 6 People can choose to do things like swimming, cooking, horse riding and bowling. There are lots of things for them to do in the home such as art sessions, music and movement and gardening; and they can also help with household chores if they are able to. People spoken with and those returned surveys told us that they were happy living at the home and had access to a variety of leisure activities. The home makes sure that residents are helped to stay healthy, and can see people like doctors, nurses, chiropodists and dentists whenever they need to. Staff are recruited in a safe way so that residents are protected from inappropriate people being employed. They are given training to make sure that they know how to support people in the right way. What has improved since the last inspection? What they could do better: The content of care plans needs to be more person centred so that it provides comprehensive details about resident’s individual preferences, goals and aspirations for the future. They should also demonstrate that residents have been involved in the planning of their care, if this is not possible the reason should be recorded. Other areas that would benefit from some attention included the following. Some risk assessments need to contain better detail about management strategies for potential risks so that staff have clearer information about how to minimise them. Care plans should contain information about recent legislation that is designed to protect people’s rights and choices. This is so the home can show they have looked at the effects the legislation has on the resident’s lives and planned their care accordingly. All areas of the home should be kept secure if necessary and areas accessible to residents should be clutter free. Hill House Nursing Home DS0000069470.V369162.R01.S.doc Version 5.2 Page 7 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 summary of this inspection report can be made available in other formats on request. Hill House Nursing Home DS0000069470.V369162.R01.S.doc Version 5.2 Page 8 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 Hill House Nursing Home DS0000069470.V369162.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 1 & 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides people with information about how it intends to operate. The home has a satisfactory system in place to assess people’s needs prior to admission. This means that people can make sure that the home can support them appropriately before they move into the home. EVIDENCE: We looked at the Statement of Purpose and the Service Users Guide, which had been updated. They were also available in an easy read format so that more people could understand them. A review of all information available prior to this visit, and the content of people care records, showed that the home does not admit residents without an assessment of their needs being completed. Residents and their relatives had been involved in the assessments and they contained clear information about what support the resident needed. Hill House Nursing Home DS0000069470.V369162.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 & 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are able to make choices about their lives and feel that they are supported to lead their lives as they prefer. Care plans do not fully reflect peoples individual care needs, goals and aspirations. EVIDENCE: We looked at four support plans for people with different needs. They contained good information about their needs, but they were not person centred in their approach. They did not contain enough information about resident’s individual preference or their goals and aspirations for the future. The Operations Manager had audited one plan and her notes indicated where further information was needed. The deputy manager discussed a file that she was currently completing which had an additional sheet identifying people’s likes and dislikes, as well as their aspirations. However this information was basic and had not been built into the care plans. Hill House Nursing Home DS0000069470.V369162.R01.S.doc Version 5.2 Page 11 Although some people had signed their care plans to demonstrate that they had been involved in planning their care, others had not. The deputy said that this was because they could not sign the record. A discussion took place regarding staff recording the reasons why plans had not being signed. Risk assessments were included in people files identifying areas of potential risk. However some did not record in full the minimising strategies, instead they said ‘see care plan’. Although the care plans concerned outlined some of the ways staff could minimise risks this information was not in enough detail. Social plans detailed residents preferred leisure activities, but evaluations did not acknowledge if people had participated in their chosen activities and if they had enjoyed them. Daily records were comprehensively completed. Regular care plan reviews had taken place and staff said that residents were involved in these if they wanted to be. Residents told us that they were happy at the home and that staff were meeting their needs. They told the expert by experience about how they participated in household jobs and led their lives as they preferred. They said that they were able to make decisions and choices about their daily lives and did so. One person told us, ‘I am happy here’ and another commented that she was able to do what she liked. The expert by experience said that he had seen staff supporting a resident well during an episode of aggressive behaviour. He also said that he had seen some ‘brilliant interaction’ between staff and residents. Staff were knowledgeable about the people they supported and the need to encourage independence, giving good examples. They described how they tried to make sure that residents were as involved as possible in making choices about their daily lives. Hill House Nursing Home DS0000069470.V369162.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported to follow their chosen lifestyle and have access to a variety of leisure activities. They also benefit from being able to choose from a varied and balanced menu. EVIDENCE: Each resident had a plan for meeting his or her social needs. Some also had a timetable of activities, but these were basic and did not cover all the activities the resident participated in. A part time activities coordinator is employed to organise the activities programme, but currently staff are providing additional support so that people can participate in their chosen activities. The deputy manager said that the home was currently looking for a full time person to provide additional hours. Hill House Nursing Home DS0000069470.V369162.R01.S.doc Version 5.2 Page 13 Various activities including gardening, movement to music, swimming, horse riding, animal care, cooking, church attendance and painting are available to residents. They can also attend a day care centre, which offered activities such as woodwork. In the extensive grounds there is an animal area where residents can care for pigs, goats and birds. Some residents also choose to help the gardener in growing vegetables for use at the home. There is an equestrian centre attached to the residential service. The provider owns some of the horses and residents own some. A number of residents help to look after the horses and the stable yards, and they have access to riding lessons and wider equestrian events held at the centre. People told us that if they were not able, or did not wish to ride a horse, carriage rides were available for everyone living at the home. There are two minibuses available to take people out into the community. Some residents had been swimming the evening before the visit and others had recently been to an Abba Mania concert. Some residents were away from the home on holidays with their families. The deputy said that holidays had also been arranged to places such as, Oxfordshire, Northumbria, Derbyshire, Lytham St Anne’s and the Norfolk Broads. Staff will accompany residents on these activities to provide support. The expert by experience said that people told him that they were able to do the things they wanted, when they wanted. However one person said that she would like to do additional things, like go to the pictures. One person told us ‘I have been riding today, I enjoy it’. Another said that she liked to play the keyboard and that someone came to the home to give lessons. Records showed that the home offers a varied menu and that residents are involved with choosing what is on it. The expert sat with residents during lunch and reported that staff interacted very well with residents and offered support as needed. He said that he also liked the fact that people were offered a choice and could change their minds at the last minute if they wanted to. He reported back that people were happy with the meals available. Hill House Nursing Home DS0000069470.V369162.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are satisfactory processes for the provision of personal and health care support, which meet the needs and wishes of the residents. People are able to manage their medications themselves if they can, but if they need help staff are trained to support them with it in a safe way. EVIDENCE: People told the expert by experience that they were happy with the way staff supported them regarding their health needs. They also told him that they could do what they wanted to. For example one resident said that they could go to their rooms when they wanted to be alone and another told him that they could have a bath or a shower when they wanted to. Each resident’s file contained a ‘health action plan’. This contained a summary of people’s health history, but the back pages of those seen were not completed. These are meant to record health related visits and provide an action plan to maintain people’s health. Other records and peoples comments showed that residents had access to outside agencies such as doctors, physiotherapists and chiropodists, dentists and opticians. Hill House Nursing Home DS0000069470.V369162.R01.S.doc Version 5.2 Page 15 Observation, records and staff comments showed that medications were being handled safely. The requirements from the last inspection had been addressed and instructions regarding not ‘potting up’ medication prior to dispensing them were contained in the information at the front of the medication records. The expert by experience commented that he liked the way staff supported people to take their medications safely. The pharmacist had undertaken regular audits to make sure that the home was following the correct procedures. Their last report raised no issues. Hill House Nursing Home DS0000069470.V369162.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected by clear policies and procedures; and staff who are trained and knowledgeable. EVIDENCE: The home has a complaints procedure, which tells residents and relatives how to make a complaint and how it will be handled. A copy is given to all new residents as part of the Service User Guide and displayed in the home. There is also an easy read version available. Information provided by the manager showed that the home had received two complaints since the last inspection. Records demonstrated that these had been correctly addressed and documented. There was also a letter on file complimenting the staff for the care and support they had provided. The people the expert by experience spoke with, and those who returned surveys, said that that they were happy at the home and had no complaints. The expert said that residents were aware of who to speak to if they had any concerns. The home has a policy and procedure about safeguarding adults from abuse so that staff know what they should do if they have any concerns in this area. Training records, as well as staff comments, demonstrated that most staff had received training in this subject either at their induction or at training sessions. Hill House Nursing Home DS0000069470.V369162.R01.S.doc Version 5.2 Page 17 Those interviewed had a good understanding of the types of abuse that may happen and who to report any concerns to. Hill House Nursing Home DS0000069470.V369162.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a comfortable and safe home, and they are encouraged to say how they want the environment to be developed. EVIDENCE: We took a partial tour of the home which included looking at the bedrooms of the residents being case tracked, as well as communal areas. The general environment was clean, tidy and homely, with no unpleasant odours. Information provided prior to the visit highlighted that a redecoration programme was in place and that the kitchen/diner had been refurbished. Some of the bedrooms had also been redecorated and residents told the expert by experience that they had been able to choose the colour scheme. Rooms were personalised and seemed very much as the resident wanted them to be, some being very tidy others having a more ‘lived in’ look. Residents said that they were happy with their rooms and the facilities provided at the home. Hill House Nursing Home DS0000069470.V369162.R01.S.doc Version 5.2 Page 19 There are extensive grounds, which include the equestrian centre and a vegetable garden, where residents help the gardener to grow crops for use in the home, and a pet’s corner. There are two halfway houses within the grounds that form part of the care home. These are used to enable residents to live more independently with a view to them moving out into the community if they are able to. The deputy manager said that there are plans to knock down some existing outdoor buildings to erect holiday chalets that will provide accommodation for people from other areas. The expert by experience said that people were happy with the facilities at the home and said that it was always clean and tidy. He highlighted some areas that he felt might be unsafe including the following. There was an unlocked cupboard with cleaning materials and one bathroom was cluttered with various things. He also said that he felt that a fan and walking stick situated on a shelf in the dining room was unsafe and could fall and injure someone. One other issue raised was that there were obstacles in the way of people getting to the keyboard in the lounge, which may stop them using it. These issues were all discussed with the deputy manager who said that these issues would be addressed. Hill House Nursing Home DS0000069470.V369162.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Procedures for the recruitment of staff are robust and therefore offer protection for people living at the home. Staff have access to training and support to help them meet the needs of the people they care for. EVIDENCE: We looked at the recruitment files for two new staff, which showed that all essential checks, such as obtaining written references and C.R.B. (Criminal Records Bureau) checks had been made prior to staff starting work. These are carried out to make sure that potential staff are suitable to work with vulnerable people. A new member of staff confirmed that the correct recruitment process had been followed and said that they were provided with a good induction to the home; records confirmed this. Records and staff comments showed that most staff had received training in subjects such as, manual handling, infection control, basic food hygiene, communication, diabetes and fire safety. The deputy manager said that some more training was also planned for the forthcoming 6 months. This included protection of vulnerable adults, an awareness of sensory needs, fire, epilepsy, autism and dementia. Hill House Nursing Home DS0000069470.V369162.R01.S.doc Version 5.2 Page 21 Information provided by the manager showed that 5 staff have completed an N.V.Q. (National Vocational Qualification) in care and 7 others are currently doing the course. Records and staff comments showed that staff support sessions and meetings had taken place and that they had received an annual appraisal. Staff were observed speaking with residents in a patient, kindly and supportive way. The expert by experience said that from his observations staff were meeting peoples needs and that he liked how staff interacted with residents. He was particularly complementary about how the staff comforted a resident who was crying. Staff said ‘it’s good here, staff work as a team’ and ‘the staff are very helpful to new starters’. Hill House Nursing Home DS0000069470.V369162.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management, guidance and direction provided to staff helps to make sure that care and support is delivered in a consistent manner. The home is managed in the best interests of the residents with opportunities provided for residents to participate in the running of the home. EVIDENCE: Since the last inspection Hazel Ashmore has been registered with us as the Registered Manager for the home. She is a qualified nurse with extensive experience of managing services for people who have a learning disability and associated needs. The expert by experience reported that residents had said that they were happy at the home. He said that they told him that they felt well cared for and safe living at the home. Hill House Nursing Home DS0000069470.V369162.R01.S.doc Version 5.2 Page 23 Staff said that the manager and her deputy were approachable and supportive. Their comments included, ‘she is a good listener and sorts issues out’ and ‘it is generally nice to work here’. However one person said that they did not always feel valued and commented, ‘I would like a thank you for doing a good job’. The home gains the views of the people who live there by holding monthly meetings and sending out annual surveys, as well as having one to one talks with people. The company also have an audit system in place to help them make sure that staff are following company procedures. There are a range of policies and procedures regarding health and safety available to guide and instruct staff. There is also a system in place to service and maintain the equipment in the home on a regular basis. Information provided to the Commission and sampling on the day of the visit showed that appropriate checks and services had taken place for equipment such as the fire system and hoists. The home has been awarded a 5 star rating by the Environmental Health Officer following their visit to look at the kitchens cleanliness and facilities. Hill House Nursing Home DS0000069470.V369162.R01.S.doc Version 5.2 Page 24 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 3 2 3 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 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Hill House Nursing Home DS0000069470.V369162.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No 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 YA6 Regulation 15 (1) Requirement Care plans must contain detailed information regarding peoples needs and preferences so that they provide clear guidance to staff as to what care is needed and how it should be delivered so that residents receive appropriate support. Timescale for action 03/11/08 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 YA6 YA6 Good Practice Recommendations The assessment of potential risks should be recorded in more detail so that staff have a clearer picture of their role in minimising the risks. Support plans should include reference to the Mental Capacity Act, 2007 and the effects it has upon the service users lives. This is to ensure that their rights and choices are protected. Hill House Nursing Home DS0000069470.V369162.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Hill House Nursing Home DS0000069470.V369162.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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