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Care Home: Hillcrest Manor Nursing Home

  • Reabrook Minsterley Hillcrest Manor Nursing Home Shrewsbury Shropshire SY5 0DL
  • Tel: 01743791851
  • Fax: 01743792573

Hillcrest Manor Nursing Home is located just outside the village of Minsterley. It is set in mature landscaped gardens surrounded by Shropshire countryside. There is a regular bus service from Minsterley to Shrewsbury and Bishops Castle. The home was originally a farmhouse and then in 1912 was extended and converted into a manor house. When first registered the nursing home comprised of just the manor house but over the years the home has increased in size with the inclusion of all the out buildings. The front door to this home is kept locked. Hillcrest Manor make their services known to prospective service users in the Statement of Purpose which is on display in the entrance hall. Hillcrest Manor`s rates are reviewed annually and service users are notified one month in advance. The only additional charges to service users are for hairdressing, newspapers, private Chiropody, private Physiotherapy, aromatherapy and escorting to hospital for routine appointments. This is clearly laid out in the terms and conditions. Fees for Hillcrest Manor are: £750 per week. All service users pay monthly by standing order or by cheque. This is two weeks in advance and two weeks in arrears.

Residents Needs:
Dementia, Old age, not falling within any other category

Previous Inspections

This may not be the latest inspection for this service as we are having techinical problems updating from CQC - please check directly on the regulators website for the most recent report; bestcarehome hopes to be back to regular updates shortly.

For extracts, read the latest CQC inspection for Hillcrest Manor Nursing Home.

CARE HOMES FOR OLDER PEOPLE Hillcrest Manor Nursing Home Reabrook Minsterley Shrewsbury Shropshire SY5 0DL Lead Inspector Pat Scott Unannounced Inspection 20th May 2008 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Hillcrest Manor Nursing Home DS0000062189.V364864.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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Hillcrest Manor Nursing Home DS0000062189.V364864.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hillcrest Manor Nursing Home Address Reabrook Minsterley Shrewsbury Shropshire SY5 0DL 01743 791851 01743 792573 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) None Kelly Residential Limited Mrs Angeline Dorothea Dilys Thomas Care Home 38 Category(ies) of Dementia (22), Old age, not falling within any registration, with number other category (38) of places Hillcrest Manor Nursing Home DS0000062189.V364864.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 with Nursing (Code N) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category (OP) 38 2. Dementia (DE) 22 The maximum number of service users to be accommodated is 38 Date of last inspection 16th May 2006 Brief Description of the Service: Hillcrest Manor Nursing Home is located just outside the village of Minsterley. It is set in mature landscaped gardens surrounded by Shropshire countryside. There is a regular bus service from Minsterley to Shrewsbury and Bishops Castle. The home was originally a farmhouse and then in 1912 was extended and converted into a manor house. When first registered the nursing home comprised of just the manor house but over the years the home has increased in size with the inclusion of all the out buildings. The front door to this home is kept locked. Hillcrest Manor make their services known to prospective service users in the Statement of Purpose which is on display in the entrance hall. Hillcrest Manor’s rates are reviewed annually and service users are notified one month in advance. The only additional charges to service users are for hairdressing, newspapers, private Chiropody, private Physiotherapy, aromatherapy and escorting to hospital for routine appointments. This is clearly laid out in the terms and conditions. Fees for Hillcrest Manor are: £750 per week. All service users pay monthly by standing order or by cheque. This is two weeks in advance and two weeks in arrears. Hillcrest Manor Nursing Home DS0000062189.V364864.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 *THREE star excellent service. This means the people who use this service experience excellent quality outcomes. We, the commission, used a range of evidence to make judgements about this service. This includes: information from the manager in the annual quality assurance assessment (AQAA), staff records kept in the home, medication records, survey results from people who use the service, discussion with the manager, tour of the premises, previous inspection reports, quality assurance processes, Fire Authority reports, Environmental Health Office reports, observation of care experienced by people using the service. What the service does well: What has improved since the last inspection? Care planning has improved as the management has changed the format to make it more person centred, clear, and readable and so residents (if able) and their families can understand the information better and be involved in the care process. Hillcrest Manor Nursing Home DS0000062189.V364864.R01.S.doc Version 5.2 Page 6 The provider has employed a second activities co-ordinator to complement the staff team. This allows for more time for activities and stimulation enabling service users with specific needs to be included in decisions about how they spend their day. A quality assurance process has been implemented which seeks the views of service users and their relatives, the results of which are fed back to staff and people involved in the home. The premises are undergoing changes to accommodate people who have dementia care needs. All people using the service now have specialist nursing beds. 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 Manor Nursing Home DS0000062189.V364864.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hillcrest Manor Nursing Home DS0000062189.V364864.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Key Standard 3. 6 not applicable. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Prospective people can be confident that the care home can support them. This is because there is a complete assessment of their needs that they, or people close to them, have been involved in. Prospective people will be able to feel that they can live the life they choose in the home. This is because the assessment is now more person centred and shows an understanding and respect for their diversity. EVIDENCE: Discussions with the manager demonstrate that the service Hillcrest Manor provides is carefully explained to people when they enquire about a vacancy. Staff provide them with information, special attention and enable them to ask questions about life in the home. The updated written information provided reinforces this personal approach. Hillcrest Manor Nursing Home DS0000062189.V364864.R01.S.doc Version 5.2 Page 9 Admission assessments of three people needing dementia care and two requiring nursing care were read. They relay the service is taking into account the individual physical care needs of a service user in a person centred way. Detailed information is written about the person’s life history and staff assess a persons strengths regarding their values, beliefs and failings in their life. All clinical assessments are very clear. The acting manager states she consults the assessment information to see if the home can meet the prospective person’s needs before they make the decision to accept the application for admission and offer a placement. Hillcrest Manor admits people with dementia and provides staff with training and guidance to enable them to be responsive to individual needs. This dementia service is in its infancy and staff are gradually building their expertise in this area of care. The provider has invested in good training resources for staff to build on current knowledge and best practice. Hillcrest Manor Nursing Home DS0000062189.V364864.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Key Standards 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. The service has a plan of care which demonstrates that the person, or someone close to them, has been involved in making it. This shows the people’s needs and goals are met and that they are able to make decisions about their life with support if they need it. People receive personal and healthcare support from staff, to be as well as they can be, and it is clear this is in a way they prefer and want. Their physical and emotional needs are met because the care plans are followed by staff. EVIDENCE: People spoken with stated that they are involved in all aspects of their life. The care plans have improved and are clearly written. Information from the Hillcrest Manor Nursing Home DS0000062189.V364864.R01.S.doc Version 5.2 Page 11 improved initial assessments is written into the plan of care. Care plans are reviewed monthly by staff with signatures from the resident or their relative. Feed back and involvement is a continuous process at Hillcrest Manor. Some people who use the service have some form of dementia and staff were observed to spend time with individuals to ensure they understood decisions and actions. Care plans demonstrate that staff actively promote the service users’ right of access to the health service both within the home and the community. Appointments are planned or arrangements are made for professionals to visit frail service users. The home operates an efficient medication system. Monthly audits by the manager ensures that staff understand their roles and responsibilities and that policy is put into practice. Induction training covers privacy and dignity. Staff respect service users privacy when dealing with personal care. They have patience with those who are confused or agitated and staff allow them to go at their own pace in all aspects of care. One person commented about her personal care: “I look nice today, dressed just how I like.” Hillcrest Manor Nursing Home DS0000062189.V364864.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Key Standards 12,13,14,15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff support people to keep in touch with family, friends and representatives so that they have appropriate relationships. People state they are as independent as they can be, and the service demonstrates that they lead their life in a chosen way so that they have the opportunity to make the most of their abilities and interests. The food in the home is of good quality so that the dietary needs of people are met. EVIDENCE: Staff know that they need to support residents socially and emotionally. The service consults and listens to people regarding the choice of daily activity through involvement of two activity co-ordinators. The service’s statement of purpose describes the activities provided. Activities carried out are recorded within an album and some photos of recent events are on display in the foyer. Hillcrest Manor Nursing Home DS0000062189.V364864.R01.S.doc Version 5.2 Page 13 A resident spoken with told us about events that take place such as; church services, brass band, and Easter activities. The service arranges for visiting therapists to provide complimentary treatments to people as assessed and agreed by the individual. A resident being attended to by a therapist stated that it enhances her well being and enjoys this type of experience. Residents look content and relaxed. Families are at ease when they visit. Staff have a good interaction with the people they look after. Menus are displayed within the dining area. The manager stated that the availability of food has been revised now that they care for people with dementia, i.e. ‘finger food’ is provided. Care plans refer to nutritional assessment and monitoring. Weights are recorded. People, who are able to give an opinion, are very complimentary about the food provided. They are not all able to state what they had chosen for lunch but some said that staff come round and ask them their preference from the menu each day. One person stated in their survey: ‘I enjoy the food; eat more than I would if I was at home. I enjoy the company’. The home has a main kitchen and a small kitchenette that requires upgrading so that residents can use this facility with staff supervision and support. Hillcrest Manor Nursing Home DS0000062189.V364864.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Key Standards 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service has a complaints procedure that is up to date and accessible so that anyone associated with the service can complain or make suggestions for improvement. EVIDENCE: The service has a complaints procedure that meets the national minimum standards and regulations. The complaint log seen details concerns received since the last inspection that have been dealt with according to the home’s procedure and resolved. The manager is clear when incidents need external input and who to refer the incident to. Links with external agencies are satisfactory and include the commission, police and adult protection teams. There have no recent incidents requiring referral through the safeguarding procedures. People who use the service and their supporters state within surveys that they are satisfied with the service provision, and feel safe and supported. Staff training records seen show that staff are provided with regular updates in adult protection. Hillcrest Manor Nursing Home DS0000062189.V364864.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Key Standards 19,26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Renewal and improvement has moved at a steady pace so that people feel they live in a comfortable, clean home with modern furnishings and facilities. EVIDENCE: Residents tell us they like their environment and individual bedrooms. A comment on a survey stated; ‘I am quite happy here it’s like home from home’. The home is comfortable and clean and alterations to meet good practice for dementia care are in progress. E.g. a local art group is going to provide pictures of interest on the walls of corridors, improved signage etc. Furnishings and fittings are well presented. Every bedroom has a nursing bed. Rooms currently shared will become single accommodation when vacant. Hillcrest Manor Nursing Home DS0000062189.V364864.R01.S.doc Version 5.2 Page 16 The home has a large well presented garden and a secure large courtyard area. The garden is being made more accessible for people to enjoy. The AQAA identified the programme of renewal of the fabric of the home. The service employs a maintenance person. Hillcrest Manor Nursing Home DS0000062189.V364864.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Key Standards 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff get access to training, supervision and support they need from the manager so that people receive planned care. Staff in the home are trained and recognise the importance of care planning so that peoples’ changing needs are identified and acted upon. EVIDENCE: There are NVQ, qualified and experienced staff employed to provide care to people at the home. The manager recognises the importance of training and reviews staff training files on a monthly basis. The provider has supported a programme to equip staff with the skills and knowledge to care for people with dementia. Mandatory training requirements for 2008 are being reviewed. The manager reported some ‘teething’ problems in providing dementia care but the staff have good support to develop their experience in this new service they are delivering. Admissions are gradual so that staff are not overwhelmed and staff are being recruited to increase the ratio of one to three people during the day and one to six at night. New senior posts have been created as ‘heads of care’ for nursing and dementia care. Hillcrest Manor Nursing Home DS0000062189.V364864.R01.S.doc Version 5.2 Page 18 Care plans show that there is understanding of the person centred way of delivering care and support which is supported by training. People using the service tell us that staff working with them provide safe and appropriate support. A relative commented; ‘Hillcrest gives my mother very good care. The care they gave her when she first went from hospital is the reason she is here today’. Three staff personnel files were selected for inspection. All the necessary identity checks have been carried out but one criminal record check and pova 1st check could not be located for one individual. The manager had recorded on file the date it came back. Hillcrest Manor Nursing Home DS0000062189.V364864.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Key Standards 31,33,35,38 National Minimum Standard 32 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The management of the home is based on openness and respect. The service has quality assurance surveys in place so that service users are assured that the overall conduct of the home is taking into account their views. People’s opinions are more central to how the home develops and reviews it’s practice, and the service is developing appropriate ways of making sure they get things right. So, people have confidence in the care home because it is run and managed well. EVIDENCE: Hillcrest Manor Nursing Home DS0000062189.V364864.R01.S.doc Version 5.2 Page 20 The manager and her staff have attended many training events and updates to complement their roles within the home. Staff files seen record all training activity. Through discussions with the manager, she demonstrates that she is confident in her ability to lead a staff team whilst being fully aware of the individual needs of the service users living at Hillcrest Manor. The manager seeks to continually improve her performance through research into best practice in elderly and dementia care. The home actively encourages people, where able, to manage their own money. Accurate records are kept. Equality and diversity for service users is promoted throughout the home within the assessments, care plans and activities. Equality for staff is promoted through the opportunities for training at all levels. Quality assurance takes place throughout the service in both a formal and informal manner. Meetings, surveys, audits, day to day contact all provide records to show that resident satisfaction is at the heart of the service. The provider and manager with administrative support implement plans for improvement The home keeps records to show that the health and safety of service users is promoted and protected. Equipment checks/services/hot water temperatures and fire safety records are seen to be maintained. The responsible individual does not produce a monthly report to the manager. This is required by the Care Homes Regulations 2001 to demonstrate that the overall conduct of the service is being managed well. The manager reported that this is not done because the proprietor is in constant contact with the home, mostly on a daily basis. The manager produces a daily service report for the responsible individual. Hillcrest Manor Nursing Home DS0000062189.V364864.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 X 14 X 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 3 X 3 X X 3 Hillcrest Manor Nursing Home DS0000062189.V364864.R01.S.doc Version 5.2 Page 22 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. 1 Refer to Standard OP19 Good Practice Recommendations The provider should organise the kitchenette so that residents who have dementia who are supported by staff can use it. Hillcrest Manor Nursing Home DS0000062189.V364864.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 Manor Nursing Home DS0000062189.V364864.R01.S.doc Version 5.2 Page 24 - 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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