Care Home: Hill View

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What the care home does well The home continues to provide residents with high quality care and support in a comfortable and well maintained home. Residents and their relatives were complimentary about the care, support, meals and choices that are provided in the home. Positive comments were received regarding the manager and care staff`s professional and kind approach and that any issues or concerns are suitably dealt with. What has improved since the last inspection? Since the last inspection the manager has introduced new documentation in the care plans. A programme of renewals and refurbishment has been undertaken, details of which are contained in this report. What the care home could do better: There were no further areas identified during this inspection. Key inspection report Care homes for older people Name: Address: Hill View 46 St Judith`s Lane Sawtry Cambridgeshire PE28 5XE     The quality rating for this care home is:   three star excellent 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: Andy Green     Date: 1 3 0 4 2 0 1 0 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 24 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Hill View 46 St Judith`s Lane Sawtry Cambridgeshire PE28 5XE 01487831709 01487831709 hillview@oakhouseltd.co.uk www.oakhouseltd.co.uk Oak House Homecare Limited Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Jennifer Anne Telford Type of registration: Number of places registered: care home 16 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 16. The registered persons may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission are within the following category: Old age, not falling within any other category - Code OP. Dementia - Code DE and Code DE(E). Date of last inspection Brief description of the care home Hill View is registered to provide care to 16 older people. The home is set in its own gardens in a quiet location on the outskirts of the village of Sawtry and approximately five minutes walk from the village centre shops and public house. Huntingdon, Cambridge and Peterborough are within a radius of approximately 20 miles. Originally a domestic bungalow, the building was extended to offer ground floor accommodation Care Homes for Older People Page 4 of 24 Over 65 0 16 16 0 Brief description of the care home in single bedrooms all of which have en-suite facilities. The home is spacious and has a large lounge off the hallway at the front of the home, a dining room with an open plan kitchen, a conservatory and a separate dedicated office used by the manager and for meetings. The home has adequate bathing and washing facilities and is wellmaintained. Hill View has a neat and well landsacaped sheltered garden with ponds, chickens and flower beds. The fees vary from £372 to £545 per week. A copy of the latest inspection report is kept in the Service Users Guide which is provided to all service users and their representatives. Care Homes for Older People Page 5 of 24 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: three star excellent 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, the Care Quality Commission, carried out an unannounced key inspection of Hill View on 13th April 2010. We inspected a number of documents including; the Statement of Purpose, assessment documents, care plans, recruitment, training, supervision and management processes. A tour of the building and grounds was also conducted. The manager completed an Annual Quality Assurance Assessment (AQAA) which is a self assessment audit that gives the home an opportunity to give their opinion about how they meet standards and regulations. Surveys were received from staff and residents. We also spoke with a number of residents and staff during the inspection to gather their opinions and views regarding the services provided in the home. Care Homes for Older People Page 6 of 24 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 24 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 24 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home carries out robust assessments to ensure that residents care and support needs are fully met. Evidence: The Statement of Purpose and resident Guide has been recently revised and updated to ensure that all information is correct. An information leaflet of Hill View is in place giving information of services provided with sample photos of the facilities available. An initial enquiry form is completed to take essential details prior to an assessment being organised. Robust assessments are carried out by the manager and a senior member of staff. The care and support needs of the individual are assessed to ensure that Hill View is able to meet their care and support needs fully. Assessment information collated includes; contact details, medical profile, personal care needs, mobility, continence, communication, sensory profile, mental state, nutritional needs/requirements, medication and allergies.The home continues to use the prospective residents assessment form so that as much information regarding the Care Homes for Older People Page 9 of 24 Evidence: person is gathered before possible admission to Hill View. If the prospective resident is funded by a local authority the home would also receive a care plan from their care manager. The home encourages prospective residents to visit as much as possible with their relatives , where appropriate, before a decision is made as to whether Hill View can meet their care and support needs. A number of residents have also had respite admissions prior to taking up permanent placements in the the home. Since the last inspection a new admission checklist document has been implemented to ensure that all information has been completed and compiled. It is clear that the home ensures that there is a smooth transition for residents so that moving in to the home is a comfortable and pleasant experience. Residents met during the inspection confirmed that the staff had been very helpful and welcoming when they had moved to the home. All residents have a contract issued to them, or to their relatives if more appropriate, which details the services included in the fee they pay. All permanent contracts include a 28 day trial period for both parties. Care Homes for Older People Page 10 of 24 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are clear and detailed care plans in place to ensure that residents receive high quality care and support. Evidence: Clear and detailed care plans are in place giving guidelines for staff to ensure that all care and support needs are appropriately met. Three care plans were seen and they contained detailed information including; Each care plan included; contact details, allergies, washing/bathing, dressing, continence, mobility, exercises, mental health needs, nutritional requirements, sensory needs, pressure care, communication, social care needs/activities, monthly weight charts and night time routines. A range of health care professionals are in regular contact with residents and separate records of appointments are kept including; district nurse visits, GP contact, chiropody and opticians. There was evidence of regular monthly reviews in place. Any changes due to medical reasons are recorded on an ongoing basis to ensure that care and support remains up to date. Daily notes are in place and amended three times during a 24 hour period so that the residents day in the home is accurately recorded/represented. Care Homes for Older People Page 11 of 24 Evidence: A new document entitled Getting to Know You has been implemented which includes the residents personal life history, family contacts, likes and dislikes, religious preferences and food preferences. All residents are registered with a local surgery with regular visits/appointments from GPs and other healthcare professionals. The manager stated that the home has a very good relationship with the surgery to ensure that residents receive high quality care. Comments received in surveys from residents and their relatives were very positive and complimentary regarding the care in the home. We spoke with a number of residents during the inspection and they all gave positive feedback regarding the kind and friendly support from the care staff. There was a cheerful and homely atmosphere in the home and interactions between staff and residents was observed to be kind, friendly and professional. The manager also showed us a number of complimentary letters and cards from relatives of residents regarding the care and support provided in the home. The home uses a monitored dosage system to administer medication and the manager carries out regular audits to monitor stock and administration records. The medication administration records were inspected and were accurately completed and double checks are made to ensure they have been recorded as required. Only senior carers administer medication and they complete ongoing training via Boots to ensure safe practice and competency. Care Homes for Older People Page 12 of 24 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a wide range of creative activities to meet the needs of residents. Meals are varied and nutritious. Evidence: The home provides a wide range of varied and creative activities to meet the needs and preferences of the residents. One of the carers has the role of activities coordinator and provides sessions, with assistance from other staff, during the week. Examples included; arts and crafts, garden projects, light exercises, bingo, quizzes, walks in the village, day trips, involvement in local village events, music, television and newspapers. Reminiscence cards and Pictures to Show books are in use which helps to promote discussions, feelings and memories. Regular events are held during the year including St Patricks day, St Georges Day, Easter and Christmas celebrations. A World Cup event is also being planned. Music entertainers regularly provide sessions throughout the year. Fund raising fetes continue to be organised to supplement the residents Comfort Fund to provide amenities in the home. A hairdresser visits the home on a weekly basis. Ministers from the local church visit residents fortnightly and representatives from other religions can be contacted to meet individual needs of residents. The manager stated that residents can have access to e-mail and Internet if they Care Homes for Older People Page 13 of 24 Evidence: wished and staff would provide assistance where required. A Wii console is also being purchased which may provide further creative opportunities for residents. Residents are free to join in activities if they wish and can also spend time in their bedrooms. Residents spoken with confirmed that they enjoyed activities that were provided and could join in if they wished. The home has purchased a new vehicle which is able to accommodate wheelchairs to aid residents access to the community. All meals are home cooked and choices are available to residents. Snacks and drinks are also readily available throughout the day. Nutritional preferences and requirements are recorded in individual care plans including special diets and any allergies. Themed food nights are organised eg Indian and Italian foods which residents can try if they so wish. Residents comments, including surveys received, were positive and complimentary about the meals provided in the home. Care Homes for Older People Page 14 of 24 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. The home has a complaints and concerns process in place to ensure that residents and their representatives have their concerns appropriately dealt with. Evidence: There have been no complaints received since the last inspection. Residents spoken to and comments in surveys showed that people were aware of how to complain if they had any concerns. The home has a complaints log to record any concerns when required. All staff have received safeguarding training and are aware of the homes whistleblowing policy. Safeguarding training is delivered by a member of staff who has undertaken the Lead Practitioner course via the Local Authority training scheme. Care Homes for Older People Page 15 of 24 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. Residents benefit from living in a comfortable, well maintained a safe environment. Evidence: The home continues to provide a safe well maintained and secure environment for all residents. The home was clean and tidy. All bedrooms are personalised and have ensuite facilities. The home is well maintained and presented in a clean and comfortable manner. One of the staff has a health & safety role and conducts three monthly checks and reports any outstanding maintenance issues to the manager/provider. The manager stated that any repairs or maintenance work is responded to by the provider efficiently. Since the last inspection of the home various renewals and refurbishments have been undertaken including; new carpets in the hallways have been fitted, new blinds and cooker in the kitchen have been installed, new washing machines, new bedding has been purchased and curtains have been renewed where needed. Decoration has been carried out to the kitchen and hallways. Decoration to bedrooms is undertaken on an ongoing basis. Residents continue to be encouraged to bring personal items to enhance their rooms and five bedrooms seen confirmed that this was the case. Residents spoken with stated that they were happy with their room and were encouraged to have personal possessions. The home continues to provide the necessary aids and adaptations to meet the Care Homes for Older People Page 16 of 24 Evidence: assessed needs of the residents and specialist equipment would be provided as required. Equipment around the home includes hand rails, grab rails, raised toilet seats and hoists. The home has access to local physiotherapy services for advice and assesments as required. Staff are dedicated to providing a clean environment that is free from unpleasant odours and infection control procedures continue to be followed. The residents have a access to a pleasant garden which is creatively landscaped. There is also an area housing three chickens which occasionally provide eggs for residents to enjoy. A gardener visits the home twice a week to maintain lawns and flower beds etc. residents are encouraged to take part in garden projects if they so wish and one resident has created a planted area near his bedroom. Care Homes for Older People Page 17 of 24 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. Residents benefit from a well recruited and trained staff to ensure that care and support is safely provided at all times. Evidence: There are sufficient staff on each shift to meet the care and support needs of residents. There is a vacancy for the post of deputy manager and it is anticipated this will be filled within the next three months. Three staff files were inspected and they contained appropriate recruitment checks including; application form, Criminal Records Bureau checks, two references, proof of identity and interview notes. Employment contracts and employee risk assessments were also seen. Thorough inductions are in place via Skills for Care and probationary review reports are carried out prior to employment being made permanent. Training is organised through out the year via the organisations training coordinator and examples of recent training included; fire, moving & handling, first aid, food hygiene, health & safety, safeguarding adults, dementia awareness, diabetes and NVQ training at levels 2 and 3. Three staff were spoken with during the inspection and they confirmed that they received ongoing training and that their recruitment and induction had been well organised. Residents surveys and comments were complimentary about the care and support provided by the staff. Relatives also confirmed that they found the care staff to be Care Homes for Older People Page 18 of 24 Evidence: kind, helpful and professional at all times. Care Homes for Older People Page 19 of 24 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. Residents benefit from a well managed and safely run home at all times. Evidence: The registered manager is experienced and has been in post since 2006. She has achieved the Registered Managers Award and NVQ level 4. The manager completes mandatory training throughout the year and also undertakes additional management training via the organisations training coordinator. Training in Deprivation of Liberty, anger & aggression, compulsive behaviour disorders, medicine management and grief and bereavement have also been achieved. Residents and relatives were complimentary about the manager and stated that they were freely able to raise issues and concerns with confidence. Staff commented that they found the manager to be responsive and approachable and that they were encouraged to be involved in the development of the home and its services. Staff receive regular recorded supervision sessions and staff meetings are also organised on a regular basis. Evidence of regular supervision and staff meetings were seen during the inspection. Care Homes for Older People Page 20 of 24 Evidence: Health and safety audits are in place and records of fire safety checks were accurate. Contracts are in place for the six-monthly/annual monitoring of services and equipment used in the home. The home was recently inspected by Environmental Health who awarded a 4 star rating. A sample of financial records, regarding money kept safe in the office for residents, were checked and found to be accurate. Care Homes for Older People Page 21 of 24 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 22 of 24 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 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 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 23 of 24 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. 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. 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