Care Home: Hillcrest - Beach Road

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What the care home does well Assessment of all people who use the service is comprehensive. There is a key worker system in place which helps to communicate all needs of people who use the service . There is a robust recruitment procedure in place to ensure the safety of people who use the service. There is a formal annual quality audit performed by head office that seeks opinions frpm people who use the service, relatives and professionals What has improved since the last inspection? There is a new central heating system in place and radiators are covered. What the care home could do better: Due to some sick leave the home has had to employ agency staff but this is to be kept to a minimum as new staff have been recruited. CARE HOME ADULTS 18-65 Hillcrest - Beach Road 61 Beach Road Littlehampton West Sussex BN17 5JH Lead Inspector Sheila Gawley Unannounced Inspection 8th September 2008 10:00 Hillcrest - Beach Road DS0000029869.V372306.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 Hillcrest - Beach Road DS0000029869.V372306.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. Hillcrest - Beach Road DS0000029869.V372306.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hillcrest - Beach Road Address 61 Beach Road Littlehampton West Sussex BN17 5JH 01903 730 120 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) beachroad@hillcrestcare.co.uk www.hillcrestcare.co.uk Hillcrest Care Ltd Jacqueline Nicole Cook Care Home 4 Category(ies) of Learning disability (0) registration, with number of places Hillcrest - Beach Road DS0000029869.V372306.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: 2. Learning disability - LD The maximum number of service users who can be accommodated is: 4 3rd October 2006 Date of last inspection Brief Description of the Service: Hillcrest Beach Road is a care home registered to accommodate up to four service users in the category LD (Learning Disability). It is a semi-detached property with a small parking area to the front and a secluded garden to the rear. It is situated in a quiet road within easy walking distance of Littlehampton town centre and the sea front. The establishment offers comfortable and domestic accommodation with service users bedrooms being located on the first and second floors. Hillcrest Care Ltd owns the service and the registered manager is Jacqueline Cook. The responsible person on behalf of the company is Mr Richard Greenwell. Hillcrest - Beach Road DS0000029869.V372306.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 site visit as part of the inspection process took place on 08/09/08. Prior to the visit all files held by The Commission for Social Care Inspection (We) were examined. We were in receipt of the Annual Quality Assurance Assessment (AQAA), which contained all of the information we asked for. The registered manager facilitated the inspection and any documents required on the day were made available. Care plans, Medicine administration charts and staff files were inspected. Some staff were spoken to. None of the people who use the service were able to express an opinion on the care received and the Commission did not receive comments on surveys for the same reason. Needs are met as per care plans and staff are aware of individual behaviours and what they mean for each individual. What the service does well: Assessment of all people who use the service is comprehensive. There is a key worker system in place which helps to communicate all needs of people who use the service . There is a robust recruitment procedure in place to ensure the safety of people who use the service. There is a formal annual quality audit performed by head office that seeks opinions frpm people who use the service, relatives and professionals Hillcrest - Beach Road DS0000029869.V372306.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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 summary of this inspection report can be made available in other formats on request. Hillcrest - Beach Road DS0000029869.V372306.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hillcrest - Beach Road DS0000029869.V372306.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 People who use the service experience good outcomes in this area because needs are assessed prior to admission. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There was evidence of comprehensive assessment prior to admission in the care plans including the care management plan from Social and Caring Services. This included information on accommodation, support, family contact, continence specific condition related needs, behaviour and academic skill. The last admission to the home was April 2004; prospective people who use the service are invited to visit for a meal or a sleep over prior to admission. Hillcrest - Beach Road DS0000029869.V372306.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 People who use the service experience good outcomes in this area because individual needs and choices are assessed and met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each of the four people who use the service has an individual plan of care, which they are involved in setting up and reviewing with their families and key worker where possible. Achievable yearly goals are set and recorded. Risk assessment is in place to allow people who use the service to take risks if possible. Needs are addressed in a person centred way, those assessed as able to take care of personal needs are allowed to do so but in practice all of the people who use the service need considerable support with personal need. Risks associated with needs or behaviours are clearly documented, as are management strategies such as for thos at risk from frequeent epilepti seizures.. People who use the service access facilities in the local community. Hillcrest - Beach Road DS0000029869.V372306.R01.S.doc Version 5.2 Page 10 Equality and diversity issues are identified and addressed such as the provision of individualised communication picture boards to aid communication with those who have difficulty in this area. There is a key worker system in place to facilitate this. The AQAA states that the home plans to look further into inclusion in the local community and possible mainstream activities. Hillcrest - Beach Road DS0000029869.V372306.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13, 15-17 People using this service experience good outcomes in this area because they a maintain an appropriate and fulfilling lifestyle have appropriate activities and are part of the community This judgement has been made using available evidence including a visit to this service. EVIDENCE: Areas of development and interest are identified in care plans and people who use the service are encouraged to achieve this. Their involvement in the local community is to be further developed. There is an activities programme in place and evidence of artwork and puzzles was on show throughout the home. None of the people who use the service currently attend college or educational programmes. Activities include cinema, bowling, swimming, car drives, shopping, walking, going to the beach and one person who uses the serviceis being assessed for horse riding. There is a list of the activities enjoyed by individuals available in the office. Family involvment is encouraged Hillcrest - Beach Road DS0000029869.V372306.R01.S.doc Version 5.2 Page 12 encouraged. All people who use the service have an annual holiday with some having been to Suffolk, Norfolk and Weymouth this year. The sitting room and dining room are well decorated and furnished in a homely style. Bedrooms are comfortably furnished and are personalised. Bedrooms have a lock and people who use the service are risk assessed for use, currently there are not any people who use the service who lock their rooms. Staff knock prior to entering bedrooms The kitchen is domestic in style. There is a varied menu in place and people who use the service are consulted on this, key workers are aware of likes and dislikes and adjust the menu accordingly. Mealtimes are relaxed and flexible and there is choice in times for getting up and going to bed. Food was not observed being prepared on the visit as the people who use the service had gone out on a car drive and on return they enjoyed a sandwich lunch, which had been delivered by a local sandwich bar. Hillcrest - Beach Road DS0000029869.V372306.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18-20 People using this service experience good outcomes in this area because they receive personal support in the way they prefer and their physical and emotional health needs are met. People who use the service are protected by the home’s policies and procedures for dealing with medicines. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Personal support required is noted in the care plans. Information is available on any specific condition and any healthcare need is clearly deatailed in care plans. The home has a holistic assessment tool which gives a fuller picture of needs and goal achievement.Staff are alert to changes in mood , behaviour early warning signals and triggers and are able to intervene . This is recorded in the plan to aid commuication. people who use the service are assisted to attend appointments as necessary to the general practitioner surgery,dentist, specialist nurses or the neurologist. A chiropodist visits the home six weekly. There is ongoing review involving people who use the service, family and social services as appropriate. There is also a daily record. Hillcrest - Beach Road DS0000029869.V372306.R01.S.doc Version 5.2 Page 14 Staff spoken to stated that the home is run in the interests of the residents and is friendly. They confirmed training, which helps them to meet the needs of people who use the service. Medicines are appropriately received, administered and recorded and policies and procedures are in place. Medicine administration charts inspected were up to date. Controlled drugs are appropriately stored and managed. The registered manager has audit systems in place to ensure policies are followed and all medicines accounted for. There are not any people who use the service who self medicate at present. The home is supported in the management of medicines by a local pharmacy. Hillcrest - Beach Road DS0000029869.V372306.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 People using this service experience good outcomes in this area because they are protected from harm and their views are listened to. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Complaints are recorded and dealt with within timescales. The complaints procedure is not as yet available in formats more likely to be understood by people who use the service but is at the draft stage. It is the policy of the home to intervene and prevent situations escalating thereby avoiding situations becoming formal complaints. There is a restraint policy in place and the home seeks to use a range of positive options to defuse challenging behaviour and prevent the need for restraint. The registered manager has attended the local safeguarding adults workshop and there is a training matrix in place, which ensures ongoing safeguarding adults training for staff. Staff spoken to confirmed they had attended this training. Small allowances are held securely for people who use the service and these are receipted and recorded. Those inspected were correct. The home does not hold bank accounts for people who use the service. Hillcrest - Beach Road DS0000029869.V372306.R01.S.doc Version 5.2 Page 16 Hillcrest - Beach Road DS0000029869.V372306.R01.S.doc Version 5.2 Page 17 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): 24,30 People using this service experience good outcomes in this area because they live in a homely, comfortable, safe and well-maintained environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The premises were inspected. The sitting and dining room are well decorated in a homely manner. There is a conservatory that is used as an activity room and a garden area. There are kitchen and laundry facilities, domestic in style. There are two bathrooms to meet the needs of the people who use the service. There were contractors in the home today repairing a bathroom leak. The electrical system has been replaced and there is a plan to have the hall and stairwells redecorated later in the year. Water temperatures are recorded monthly and evidence of fire equipment testing was seen. Hillcrest - Beach Road DS0000029869.V372306.R01.S.doc Version 5.2 Page 18 Hillcrest - Beach Road DS0000029869.V372306.R01.S.doc Version 5.2 Page 19 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): 32,34,35 People using this service experience good outcomes because they are supported by competent and qualified staff and are protected by the homes recruitment policy, practices. Staff supervision and training is up to date. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are suitable numbers of competent staff on duty at all times to support people who use the service. Staff are well informed about individuals needs. Due to sick leave the home has had to use agency staff of late approximately 2 shifts monthly, the home uses one agency and receive regular carers. Two new staff have been recruited and this is hoped to further reduce and eventually eliminate eliminate the need for agency use. There is a robust recruitment procedure in place. Staff files inspected contained a Criminal Records Bureau Clearance and POVA check, two references, application form with employment history. Training and supervision records were seen in staff files. Hillcrest - Beach Road DS0000029869.V372306.R01.S.doc Version 5.2 Page 20 There is a mandatory trainiing programme in place and all staff receive induction. National Vocational Qualification level 2 and 3 is undertaken and also condition specific training such as that on epilepsy, administration of medicines, challenging behaviour, autism, report writing, intervention techniques and personal relationships. Two staff member spoken to stated that the organisation is very supportive and confirmed that they received training and supervision. Hillcrest - Beach Road DS0000029869.V372306.R01.S.doc Version 5.2 Page 21 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): 37,39,42 People using this service experience good outcomes because the home is run in their best interest, their health and safety is protected and their opinions are sought. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a registered manager in place. She has completed an National Vocational Qualification Level 4 in care and the Registered Manager Award. She facilititated the inspection and had up to date policies, procedures and documents as required. Key workers elicit opinions and choices on a daily basis from people who use the service. There is a formal annual quality audit performed by head office Hillcrest - Beach Road DS0000029869.V372306.R01.S.doc Version 5.2 Page 22 that seeks opinions frpm people who use the service, relatives and professionals. Results of this audit wereseen and relatives commented that they were kept informewd of change; professionals responded that their clients needs are fully met. There are monthly staff meetings. Health and safety matters are addressed as they arise and regular checks made to ensure the health and safety of all service users and staff. Staff are trained in COSHH, Health and Safety, Fire, Food Hygiene, Moving and Handling, and First Aid. This is monitored by the manager. The home is maintained and areas which relate to electrical safety, boiler maintenanace, water temperatures, equipment servicing are documented. Hillcrest - Beach Road DS0000029869.V372306.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 4 5 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 DS0000029869.V372306.R01.S.doc X X X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Hillcrest - Beach Road Score 3 3 3 x 3 X 3 X X 3 X Version 5.2 Page 24 No 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Hillcrest - Beach Road DS0000029869.V372306.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Hillcrest - Beach Road DS0000029869.V372306.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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