Care Home: Hillcrest House

Similar services:

• Hillside
• Applegarth
• 122 Scorer Street
• Jubilee Villa Care Home
• Thornham Grove
• Beech Lodge
• 8 Thorndale Road (Homefield College)
• Hunter`s Lodge

What the care home does well The home provides continuous assessment of individuals needs. Support workers are very knowledgeable about the needs of people who use the service. Health care needs are monitored and appropriate action is taken. People using the service have a range of daily activities of their choice. They are supported to access community resources. `We feel safe living here and know who to talk to`. The home is maintained to a high standard and people using the service have access to individual rooms that reflect their personal preferences. Communal areas enable a range of activities to be undertaken within a family setting. The support workers show a high level of commitment to the work and bring a range of skills to support individual`s needs.Good management ensures that people who use the service are listened to and that support workers are trained and supported. `We are included in the recruitment of support staff at the home`. The home has strong leadership that encourages reflection on the service provided. What has improved since the last inspection? A review of the assessment process has taken place to ensure that the service can fully meet the needs of people making an application. Additional work has been completed to ensure that the recruitment process is robust. CARE HOME ADULTS 18-65 Hillcrest House 3 Hillcrest Avenue Spinney Hill Northampton NN3 2AB Lead Inspector Judith Roan Unannounced Inspection 16th May 2008 2:00 Hillcrest House DS0000070580.V364676.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 House DS0000070580.V364676.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 House DS0000070580.V364676.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hillcrest House Address 3 Hillcrest Avenue Spinney Hill Northampton NN3 2AB 01604 495155 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) PhiLori Care Ltd Lorraine Graham Care Home 5 Category(ies) of Learning disability (5), Mental disorder, registration, with number excluding learning disability or dementia (5) of places Hillcrest House DS0000070580.V364676.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only: Care Home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the following are within the following categories: Mental Disorder, excluding learning disability or dementia - Codes MD and MD(E) Learning Disability - Codes LD and LD(E). The maximum number of service users who can be accommodated is: 5 3rd December 2007 2. Date of last inspection Brief Description of the Service: Hillcrest is a small care home situated in a residential area close to local shops and amenities. Good public transport provides good access to the town and wider community. People using the service all have single rooms with private facilities. The fees for the service are stated within the information available to potential users of the service and commissioners. Fees will vary according to assessed need. Hillcrest House DS0000070580.V364676.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 3 star. This means the people who use this service experience excellent quality outcomes. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for people who use the service and their views of the service provided. This process considers the services capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. The primary method of inspection used was ‘case tracking’ which involved selecting 2 people who use the service and tracking the care they receive through review of their records, discussion with them, the support staff and observation of care practices. The homes registered manager completed an Annual Quality Assurance Assessment (AQAA) a questionnaire required by CSCI. The inspection was unannounced and was undertaken during the afternoon and evening lasting 6 hours. This inspection included a thematic probe on safeguarding. A thematic probe is how we gather additional information on a particular theme from a key inspection. All key inspections completed 5-16 May 2008 had a thematic probe. What the service does well: The home provides continuous assessment of individuals needs. Support workers are very knowledgeable about the needs of people who use the service. Health care needs are monitored and appropriate action is taken. People using the service have a range of daily activities of their choice. They are supported to access community resources. ‘We feel safe living here and know who to talk to’. The home is maintained to a high standard and people using the service have access to individual rooms that reflect their personal preferences. Communal areas enable a range of activities to be undertaken within a family setting. The support workers show a high level of commitment to the work and bring a range of skills to support individual’s needs. Hillcrest House DS0000070580.V364676.R01.S.doc Version 5.2 Page 6 Good management ensures that people who use the service are listened to and that support workers are trained and supported. ‘We are included in the recruitment of support staff at the home’. The home has strong leadership that encourages reflection on the service provided. 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 House DS0000070580.V364676.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 House DS0000070580.V364676.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): 2,5 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The assessment practices & process at the home has improved after initial problems. EVIDENCE: All of the people living at Hillcrest House are new having moved in since it was opened in December last year. It is evident from case tracking the records that a through assessment of need was undertaken by the homes manager at the time of admission to ensure that their individual needs could be met. One admission however that resulted in the person moving to alternative accommodation has led to a review of how information during the assessment process is sought and verified. The registered manager has demonstrated that the service has learnt from the experience and that people using the present service can be assured that future admission will ensure that their needs can be met. The assessments seen as part of the case tracking were detailed and gathered information the individual person making the application, their family, previous placements and the funding authorities. This information is updated with ongoing work especially in relation personal and social developments. Hillcrest House DS0000070580.V364676.R01.S.doc Version 5.2 Page 9 Individuals files held contracts made with the provider and the person receiving the service. An additional contract is made with the funding authority. Hillcrest House DS0000070580.V364676.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): 6,7,8,9,10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Support plans are person centred and demonstrate full involvement of people using the service. EVIDENCE: Care plans are now in place for people who use the service and are reviewed as required. Regular forums in which support needs of individuals are reviewed ensure that there is continuous development. Good record keeping ensures that information is shared appropriately. Confidentiality is maintained with all support workers understanding the importance of keeping personal information in secure files. All people using the service have access to their files and confirmed that support plans had been developed with them. The outcomes for people using the service support are positive and that needs are being met within the systems in place at the home. In discussion with support workers it was evident they are very knowledgeable about the needs of the people they support. A new support worker informed the inspector that they had worked alongside another experienced worker until they has demonstrated that they were competent and confident in meeting Hillcrest House DS0000070580.V364676.R01.S.doc Version 5.2 Page 11 individual’s needs. Feedback from families all confirmed that they pleased with how their family members progress. In reviewing the files and in discussion with individuals using the service it was evident that they were being assisted to develop their skills and participate in everyday activities that they previously were not able to achieve. Learning is achieved by the consistent approaches used by support workers and people using the service having access to a broad spectrum of daily living activities. Risks within activities are considered on an individual basis and plans made to minimise these for each person. Files contained comprehensive risk assessments related to individual’s activities. People using the service are encouraged to be as independent as possible with appropriate support. In this way people using the service are included within activities and not excluded because of any behaviour that may arise. Hillcrest House DS0000070580.V364676.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): 11,12,13,14,15,16,17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. A wide range of personal, educational and social options are available and promote individual development EVIDENCE: Individuals have a weekly activities programme that is updated to take into account of various events and personal choices. New activities are tried out to extend the choices and experiences for each person. Since moving into the service all of the individuals that the inspector spoke with had developed communication skills and were fully involved in activities outside of the home. Careful planning is undertaken for all activities to ensure that people who use the service and support workers are protected and enjoy the experience. Experiences are good and varied. It was noted that several people attend college and work opportunities are being sought. People using the service are fully involved with day-to-day living tasks within the home. Each person takes it in turn to prepare the evening meal. Individuals choose a meal from a selection they all enjoy. The process supports people to experience all aspect of the meals preparation from check out supplies, purchasing the food and Hillcrest House DS0000070580.V364676.R01.S.doc Version 5.2 Page 13 cooking the meal. In observation support workers enable people to carry out tasks and help only when necessary to demonstrate and skill. It was clear that individuals were positive about their achievements. Throughout the inspection the inspector observed positive work with service users using strategies noted within the care plans in supporting people with behaviours that challenge. The teatime meal was freshly cooked and healthy. Individuals are supported to make healthy choices and have a balanced diet, with opportunities to have the occasional not so healthy treat. Support workers have a good understanding of the needs for people who use the service and use the meal times to develop communication skills with each other. Meals were seen to be a very social event at the home. There is much negotiation between individuals so that meal times can be arranged around social activities. The standard of food prepared at the home is high being produced from fresh produce. A food diary is kept to ensure that a balanced diet is provided. Families commented on how good the communication has been with them and that the registered manager and the team of support workers always kept them informed. Hillcrest House DS0000070580.V364676.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): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service are positively supported to access local and specialist healthcare services. EVIDENCE: Service users are supported to have regular health checks and there is evidence on files that healthcare appointments are made. The AQAA confirms that people using the service ‘are supported with individual programmes to promote their health i.e. smoking contracts, CAN (Aquarius for alcohol addiction), fitness programmes, CALM (anger management) etc’ Personal support is provided in a discreet manner and with people using the service preferences being a top priority. Medical profiles for people who use the service have clear information. All medication is stored in a locked facility and records were well maintained. The provider needs to seek appropriate advice on the storage of controlled drugs since the change in the regulations last year that requires all care homes to have facilities in place. ’ Hillcrest House DS0000070580.V364676.R01.S.doc Version 5.2 Page 15 All incidents are recorded on file to show how the manager/support workers have reviewed practice to minimise future risks. All incidents are reported to the CSCI with there being positive communication between the inspector and registered manager and outcomes. Hillcrest House DS0000070580.V364676.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): 22,23 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Practices within the service fully protect people who use the service and ensure that they are listened to. EVIDENCE: The service has comprehensive policies and procedures in relation to handling concerns and complaints. People who use the service were all clear about how to make a complaint saying they would speak with the manager or a member of their family. Support workers undertake abuse awareness training as part of their induction/ foundation training. Several have completed this as part of their National Vocational Qualification. The inspector checked out their understanding during the inspection. The in-house training is inclusive of people using the service and staff. In this way everyone is fully aware of what abuse is and how to raise concerns. The open approach of the registered manager enables people who use the service to feel comfortable if there was a need to make a complaint or express a concern. There have been no complaints since the last inspection. Over the past few months the staff team at the service has managed a safeguarding incident. This has resulted in an individual moving to a more suitable service. During this time staff have protected individuals and acted speedily to resolve the issue. The manager has used the experience to reflect on the admissions procedure and how information is gained. Had certain facts been available during the assessment process a different outcome would have been chosen. Hillcrest House DS0000070580.V364676.R01.S.doc Version 5.2 Page 17 The thematic probes into safeguarding practices concluded that people using the service felt safe and that support workers had a good understanding of their role and were aware of policies and procedures. Hillcrest House DS0000070580.V364676.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): 24,30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home provides a warm family setting with individual space that is well maintained clean and hygienic. EVIDENCE: The home is newly converted to a residential unit that is decorated to a high standard. There are adequate rooms to enable everyone to have their own personal space. Several communal areas are used for joint activities and each bedroom has and sufficient room for personal hobbies. The AQAA states that ‘There is an activity room (with computers, internet access, television, playstation, pool table, craft table, many games and puzzles.’ Individual bedrooms can be personalised they are comfortable and well maintained. People using the service are supported in maintaining their rooms to a high standard of cleanliness and safety. There is a family size kitchen that is large enough for people who use the service to assist or sit comfortably and be part of meal preparations. Hillcrest House DS0000070580.V364676.R01.S.doc Version 5.2 Page 19 The garage has recently been converted into a gym that provides a further room for individual space. The garden provides areas for relaxation when the weather is fine. People using the service are supported and encouraged to play an active role in its maintenance. Hillcrest House DS0000070580.V364676.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): 32,34,35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff skills and recruitment practices ensure that the needs of people who use the service are supported and that they are protected. EVIDENCE: The support worker team have a sound knowledge base about the needs of people that use the service. Through observation during the inspection the staff team showed that they had a range of skills to support individuals and were proactive in developing everyday living skills. Since the last inspection the inspector has received a complaint about recruitment practices within the service. In reviewing the files of support workers it was noted that all recruitment checks had been undertaken. Files all contained application forms, two references, identity check and an enhanced criminal record bureau disclosure. In discussion with the manager it was established that improvements could be made in relation to references to ensure that one was sought from the previous employer. Since the complaint the Registered manager had taken steps to gain these but the previous employer has failed to respond. Hillcrest House DS0000070580.V364676.R01.S.doc Version 5.2 Page 21 A new support worker was on shift at the inspection and they were positive about their induction which they are working through with the registered manager. Other files showed that staff had completed induction and other core training. The new support worker had as part of their induction worked alongside an experienced member of the team to gain full knowledge about the needs of all people using the service at the home. Support workers are offered a range of opportunities to train. Of the staff team 6 people have National Vocational Qualification (NVQ) level two or above and a further 4 are working towards the qualification. Hillcrest House DS0000070580.V364676.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): 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 service is person centred and effectively managed in their best interests. EVIDENCE: The Registered Manager effectively manages the home in the best interests of people who use the service and the support workers. There are several internal meetings within the service that focus on person centred care and enable people to voice their views and choices. The registered manager is developing the services quality assurance system The AQAA states that ‘The manager and senior team ensure that the service is client led by listening to clients, seeking their opinion about all aspects of their care including regular client CPA (care plan approach) meetings and reviews. Seek feedback from clients, care management and client representatives. Client meetings held each week’. Hillcrest House DS0000070580.V364676.R01.S.doc Version 5.2 Page 23 During the inspection the registered manager discussed with the inspector the need to include reflection on incidents within the quality assurance process to demonstrate learning and development of the service. The provider has undertaken all health and safety checks required. The AQAA confirms the checks undertaken. Hillcrest House DS0000070580.V364676.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 X 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 4 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 4 4 4 4 4 LIFESTYLES Standard No Score 11 4 12 4 13 4 14 4 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Hillcrest House DS0000070580.V364676.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 YA20 Regulation 13 (2) Requirement The provider must review the site of the controlled drugs cabinet to ensure that they are safely stored and meet the new regulations that came into force in 2007. Timescale for action 31/08/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Hillcrest House DS0000070580.V364676.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 Hillcrest House DS0000070580.V364676.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. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!