Care Home: Hillcrest Residential Care Home

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What the care home does well The people I spoke to said they were very happy with the care and support they received at Hillcrest Care Home. They told me that the care staff were `very supportive, helpful and cheerful`. A visiting health care professional said that staff were `very good and always professional`. The residents at the home were very well presented, clean, comfortable and looked cared for. The admission procedure to the home was excellent, people were properly assessed before moving in, and staff were aware of their responsibilities with regards to supporting and caring for people, in order that their assessed needs could be met. People`s care plans were written in detail and staff had a very good knowledge of what care was needed in order that people were looked after properly and safely. People who live at the home confirmed that they knew how to raise a concern or make a complaint if they needed to. One person said they would speak to a member of care staff if they were unhappy. Another said that they would get a relative to speak to someone on their behalf. Staff are aware of their responsibilities if they believe that neglect or poor Practice was taking place, and were confident that if they raise any issues that it would be investigated. Most of the communal areas and bedrooms in the home has been refurbished and redecorated to a very high standard. The home is clean and well-maintained and the furnishings are good quality. There are thorough recruitment and selection procedures in place to make sure that staff are suitable and safe to work with people who live at the home. People who live at the home told me that staff were `fantastic`, another person said `the staff are great, the food is good what more could I ask for?`. One member of staff said `I love working here, it would really upset me to think I would have to leave, this place has comes such a long way over the past few months and I want to be a part of it.` What has improved since the last inspection? This is the first time this service has been inspected since it was registered with the Care Quality Commission. Over the past six months there has been great improvement in terms of the environment in which people live, the lifestyle of the people in the home, and the quality of care staff who are employed at the home. Building work is continuing on the upper floor, and refurbishment and redecoration is also taking place. This work is being carried out to an exceptionally high standard and once completed will provide excellent accommodation for the people who live at home. What the care home could do better: The system for ordering and receiving people`s medication needs to be reviewed, to make sure people get their medication properly and that it is ordered and delivered from the pharmacy in good time before they run out of their prescribed tablets. Key inspection report Care homes for older people Name: Address: Hillcrest Residential Care Home Byng Road Catterick Garrison N Yorkshire DL9 4DW     The quality rating for this care home is:   two star good 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: Bridgit Stockton     Date: 2 6 0 1 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 21 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) 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. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 21 Information about the care home Name of care home: Address: Hillcrest Residential Care Home Byng Road Catterick Garrison N Yorkshire DL9 4DW 01748834444 01748832619 hillcrestcarehome@tiscali.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Sirtin Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: care home 34 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is 34. The registered person may provide the following category pf service only: Care home only: Code PC, 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: Code OP, Dementia: Code DE, Physical disabiity: Code PD. Date of last inspection Brief description of the care home 0 0 1 Over 65 8 34 0 Care Homes for Older People Page 4 of 21 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: two star good 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: This was the first inspection of Hillcrest Care Home. The purpose of this inspection was to assess the quality of care and support received by the people who live at the home. The methods I use to gather this information included a visit to the home, conversations with the people who live there, their relatives, healthcare professionals and staff. I looked in detail at the care and support of four people, examined other records and looked around the home. I spent six hours at this home. Care Homes for Older People Page 5 of 21 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. Care Homes for Older People Page 6 of 21 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 21 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 21 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. People care be assured that their care needs are properly assessed prior to moving into the home. This will make sure that the home has the right resources to care and support the person at the home. Evidence: People are properly assessed before moving into the home. We saw documentation in peoples care plans of assessments that had been undertaken prior to people moving into the home. We were told that the manager or the head of care goes to the persons home or hospital to assess their needs. On the day of the inspection a new admission was expected to the home in the afternoon. Staff were aware of what care and support was needed to ensure that this persons needs were met fully. The persons bedroom has been prepared for their admission. Placed on the bedside table was a bowl of their favourite fruit, and a radio. It was documented in the persons admission assessment that this person liked to Care Homes for Older People Page 9 of 21 Evidence: listen to a certain radio channel in the afternoon, and the manager had made sure that staff were aware of this and that a radio had been made available. Social service assessments were also seen on peoples care plans, staff told me that they used the assessments to help formulate peoples plans of care in conjunction with their own assessment documentation. Care Homes for Older People Page 10 of 21 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Excellent systems are in place to ensure that health care needs of the people are met . People can be confident that their privacy and dignity is protected and that they are treated with respect to all times. Evidence: I looked at four care plans in detail, to make sure that peoples health and personal care needs are being met in the way of person prefers. The plans were very well written and gave detailed instructions to staff on what care support was expected from them in order that peoples needs were met fully. The plans contained risk assessments on such things as moving and handling and the prevention of pressure sores. The plans could be developed further by including nutritional assessment documentation and pain assessment charts. There was evidence of involvement from specialist healthcare people such as the community nurses and the dietitian. A district nurse was visiting the home at the time of the inspection. She said the staff were knowledgeable about the people they were Care Homes for Older People Page 11 of 21 Evidence: caring for, and that she received timely referrals from the home when district nurse input was required. I was told that each resident has had a health MOT at the local doctors within the last six months. This has made sure that everyone is as far as possible fit and healthy. I looked at how peoples medication was managed at the home. Administration of medication is carried out properly, and there are audits in place to make sure that the people are in receipt of the right medication. During the inspection it came to light that there had been a delay in a persons prescription being collected from pharmacy, resulting in them missing their medication for a day. Staff need to be more vigilant with regards to stock control of peoples medication, so that they so that people get their prescribed medication as and when it is required. I was also informed during the inspection that shortly a new system of medication administration was to be introduced into the home, this should also reduce any potential errors that may occur regarding peoples medication. People were treat with dignity and respect, it was observed that care is carried out discreetly and staff are aware of how people should be treated in order that their dignity and privacy is protected at all times. Staff were seen to be treating people sensitively and their approach was very caring and supportive. Care Homes for Older People Page 12 of 21 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 recreational and social needs of people are excellently catered for, which enables them to make daily choices and promotes independence. Evidence: Staff were very welcoming to the home, and there was a very inclusive atmosphere. Visitors were coming and going throughout the day and said they were made to feel very welcome. Most people sat in the large spacious communal lounge area. Some were watching television or reading newspapers or chatting with the staff. People told me that there were organised activities for them to partake in. An activities program was on display it was varied and included church services, craft sessions, visiting entertainers and quizzes. People told me that the food was excellent. I spoke with the cook, she was very knowledgeable about Peoples choice on what they liked to eat. She told me that she catered for varying diets such as gluten-free and diabetic diets. The lunchtime meal was observed. The food looked lovely and people said it tasted very nice. There was sufficient staff on duty to assist and support people over the mealtime discreetly. People told me they could more or less please themselves with what they did during the day. One person said there is always something going on, if I want to join in I Care Homes for Older People Page 13 of 21 Evidence: can, I can just please myself. In all the communal areas there was jugs of fresh juice and water. There was also bowls of fruit in the communal lounges for people to help themselves to. Care Homes for Older People Page 14 of 21 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. People can be confident that their concerns and complaints are dealt with appropriately and safeguards are in place to protect them from abuse. Evidence: There are written policies and procedures in place to deal with any complaints, and the care staff I spoke with confirmed that they were aware of these. Staff knowledge of this helps ensure that they are able to address any issues or anxieties of residents, relatives and visitors to the home promptly. Staff told me that training had taken place in the protection of the protection of vulnerable adults in abuse. I looked at four personnel files and found that staff recruitment procedures are good and staff were employed and deployed following appropriate checks. The owner of the home and staff team were clear and confident in the protection of vulnerable adults procedures. Care Homes for Older People Page 15 of 21 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean safe and well-maintained comfortable environment. Evidence: The home was purchased by the new owners six months ago. Since this time there has been major financial investment within the building. Windows have been lowered to enable people to look out and create a bright and airy atmosphere. The toilets and communal bathing facilities has been upgraded to a very high standard. The communal lounge on the ground floor has been redesigned and offers a variety of seating arrangements for people to choose from, a fire place has been installed as a focal point in the room, and it felt homely. Bedrooms have been refurbished and redecorated, and new furniture has been bought. There has been investment in the provision of equipment for the laundry and the kitchen. Work is still ongoing on the upper level of the home, when this is completed it will provide a rooftop conservatory, and additional bedrooms. The home was exceptionally clean and tidy and smelt fresh and clean. During the inspection a domestic assistant was spoken with. She told me she had worked at the home for a long time, she has been trained in infection control, first aid and health and safety. She said she was given enough equipment to do her job properly and felt very supported by the management at the home. Care Homes for Older People Page 16 of 21 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. Staff are knowledgeable, skilled and on duty in sufficient numbers to meet the assessed needs of the people who lived at the home. Evidence: I looked at the staff rota. It suggested that there were enough staff on duty at all times to meet the needs of the people who live at the home. People told me that the staff were great and very helpful. Good quality training is provided for staff in during the inspection some training was taking place. Staff said they really enjoyed the training sessions and were keen to learn. Mandatory training sessions has taken place in the protection of vulnerable adult, infection control, moving and handling and first aid. Staff who were spoken to during the inspection said that they felt that the training they received was very good and relevant to the job. Some staff files were inspected, they demonstrated that staff were recruited properly and appropriate checks taken place before they started to work at the home. Care Homes for Older People Page 17 of 21 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. People who live and work at home can contribute to the decision-making processes, this makes people feel valued and respected. Evidence: Currently the home does not have a registered manager, however there is an experienced manager from another home within the group providing managerial support and guidance to staff and people who live at the home. The homeowner is also heavily involved in the day-to-day management of the home. Resident and relatives meetings are held and are well attended. The home is about to send out questionnaires to relatives in order to gain information about how people view the service and what improvements they would like to see over the next few months. Some peoples finances are managed by the home. these were checked and found to be in good order, receipts for all transactions are kept. Health and safety checks at the home are carried out in a timely manner.Staff have basic health and safety training. All these measures make sure that the health, safety and welfare of the people who live and work at home is promoted and safeguarded. Care Homes for Older People Page 18 of 21 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 19 of 21 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 1 9 13 Peoples medication must ordered and received from pharmacy promptly, and safeguards put in place to ensure people do not run out of their prescribed medication. This will make sure people receive their medication safely. 26/03/2010 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 1 7 Additional assessment tools for nutrition and pain control could be incorporated into the care plans where appropriate, which would further enhance peoples planned care. Care Homes for Older People Page 20 of 21 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. 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