Care Home: Hillside Lodge

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What the care home does well The home continues to be decorated and furnished to an excellent standard with attractive communal areas and bedrooms. Residents and relatives spoken with made very positive comments about the care provided by the permanent staff team. Permanent staff we spoke with confirmed they receive a full induction and participate in a range of training appropriate to the needs of the residents. What the care home could do better: Hillside Lodge continues to have a high percentage of vacancies within the establishmenthours for care. This has resulted in continued heavy reliance on agency staff to cover vacant shifts. However, the management of the use of agency staff is a cause for concern. Agency staff who are deployed to work with residents who have dementia should be appropriately trained to do so. The skills mix and experience of staff within teams on each unit, particularly on the unit where residents who have dementia, should be more evenly distributed across each unit. Staff caring for residents with dementia must have received training in dementia and challenging behaviour to protect both residents and staff. The standard on cleanliness in some areas of the care home is unsatisfactory. Random inspection report Care homes for older people Name: Address: Hillside Lodge Spiro Close London Road Pullborough West Sussex RH20 1FG one star adequate service 26/01/2010 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme 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 review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: David Bannier Date: 1 1 0 8 2 0 1 0 Information about the care home Name of care home: Address: Hillside Lodge Spiro Close London Road Pullborough West Sussex RH20 1FG 01798877700 01798875978 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Judith Anne Allerton Type of registration: Number of places registered: Conditions of registration: Category(ies) : Shaw Healthcare Ltd care home 60 Number of places (if applicable): Under 65 Over 65 0 60 dementia old age, not falling within any other category Conditions of registration: 60 0 The maximum number of service users to be accommodated is 60. The registered person may provide the following category of service only: Care home with nursing (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) Dementia (DE) Date of last inspection 2 6 0 1 2 0 1 0 Care Homes for Older People Page 2 of 10 Brief description of the care home Hillside Lodge is a modern three-storey home registered to accommodate up to sixty people for personal care, dementia and nursing need. Each floor accommodates up to 20 residents who are allocated rooms dependant on their assessed need. The premises are owned by Shaw Healthcare Ltd and are built for specific purpose. The home is situated very close to shops and is on the outskirts of Pulborough village. The registered provider has appointed Mr Peter Nixey to be the responsible individual and to supervise the management of the care home. Mrs Judith Allerton is the registered manager and is responsible for the day to day management of the home. Fees range from approximately £360 to £829 per week. Care Homes for Older People Page 3 of 10 What we found: We carried out a key inspection in January 2010 and our findings indicated that residents were receiving an adequate service and the service was rated one star. At that time we found staffing levels at the home had not improved since our previous visit. A large number of agency workers are used to cover shifts. This did not promote a consistent approach in the care provided and could pose a potential risk to residents. As a result we made a requirement that the provider must ensure there are sufficient staff on duty who are suitably competent, qualified and experienced to meet the needs of residents Since that time we have received several complaints from relatives which has resulted in the Commission raising safeguarding alerts with the local authority. We have also noted that complaints received have included a common concern about insufficient staff on duty and heavy reliance on agency staff to cover vacancies. On arrival we were informed that as the registered manager was on annual leave and the deputy was absent from work, the registered provider had arranged for a deputy manager of another service to provide day to day management. We informed the acting manager that the purpose of this visit was to gather evidence to determine if the requirement made after our last visit had been met and that residents accommodated were safe. We were given information about the weekly establishment numbers provided at Hillside Lodge. This demonstrated that 26 of the weekly establishment numbers for care staff are currently vacant. This equates to approximately 400 hours per week, which is about the same amount as we found at our last visit. We visited the unit where people who have dementia lived. We found a resident in considerable distress. We were accompanied by the acting manager who dealt with the sitiuation and helped the resident to calm down. The acting manager also informed us there had been an incident the night before. As they were concerned about the safety of other residents accommodated the acting manager raised a safeguarding alert with the local authority and called in the GP. We were also informed that staff had been instructed to observe the resident every 15 minutes. We did not observe this taking place. No member of the staff team went to see what was wrong whilst the resident was in distress. The acting manager had to find an agency staff to inform them to look after the resident. We continued to observe the agency staff interacting with the resident. After a few minutes the resident became distressed again but the agency staff member did not appear to know how to engage with the resident in order to calm the the resident down. We expressed concern to the acting manager three of the five staff working on this unit were agency staff who had worked no more than four shifts previously. In addition, none of the agency staff and only one member of the permanent staff, identified as the team leader, had any training in caring for people who have dementia. The other member of permanent staff had been in post since April. We were told that their training was due to start the following week. The training would be carried out by the team leader but they were not able to tell us how this time would be covered in the unit. We looked at the profiles of two agency staff who were working with residents who have Care Homes for Older People Page 4 of 10 dementia. This included a record of the training that confirmed they had received training in manual handling, first aid, infection control and food safety. When we entered this unit we noted that there was very unpleasant odour. We also noted that some bedrooms had not been cleaned even though it was late morning. We also noted there was a bed sheet that had been taken of someones bed and left on a shelf just outside the dining room of the nursing unit. We were informed that there is one domestic staff employed for each unit. We were informed that, currently there are 17 residents accommodated on each unit except for the residential unit located on the ground floor where 18 residents are accommodated. We also visited the units that accommodated elderly people who require nursing and residential care. Each of these units had all permanent members of staff on duty. We observed care practices and noted the marked difference in the atmosphere on these units. They were homely and calm. residents were receiving visitors or getting on with their daily routines, receiving help where necessary from staff on duty. We spoke to residents and to visiting relatives. Comments made were very positive about the care provided. A relative informed us, My mother moved here about three years ago. She has settled very well. We were offered a placement at another home which is nearer to where we live. But we decided to keep her here as she is quite happy. The relative also told us, The staff are quite busy, especially at weekends. There can sometimes be bank staff on duty we dont know. There are usually one or two permanent staff on duty. We go to speak to them if we need to as they have a background understanding of my relatives needs. A resident told us they found the staff very pleasant and very helpful. Another resident told us that the staff were helpful but they could only do so much as they are so busy. We spoke to staff on duty on all units visited. The permanent staff told us about the training, induction and support they had received. This was comprehensive and included fire safety, health and safety, food hygiene. Some members of staff informed us they had also been trained in working with residents who have challenging behaviours and had, on occasion worked on the unit accommodating residents with dementia. What the care home does well: What they could do better: Hillside Lodge continues to have a high percentage of vacancies within the establishment Care Homes for Older People Page 5 of 10 hours for care. This has resulted in continued heavy reliance on agency staff to cover vacant shifts. However, the management of the use of agency staff is a cause for concern. Agency staff who are deployed to work with residents who have dementia should be appropriately trained to do so. The skills mix and experience of staff within teams on each unit, particularly on the unit where residents who have dementia, should be more evenly distributed across each unit. Staff caring for residents with dementia must have received training in dementia and challenging behaviour to protect both residents and staff. The standard on cleanliness in some areas of the care home is unsatisfactory. 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 set out on page 2. Care Homes for Older People Page 6 of 10 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 10 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, 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 26 23 All areas of the care home must be kept to a good standard of hygiene This will ensure all areas are kept free from offensive odours 19/08/2010 2 30 18 The skills mix and experience 19/08/2010 within each team allocated to work on each unit must be sufficient to meet the needs of the residents accommodated on that unit This will ensure the needs of residents are met. 3 30 18 Staff who provide care and 19/08/2010 support to residents who have dementia must be trained so they are able to carry out the duties required of them This will ensure the safety and wellbeing of residents who have dementia is maintained Care Homes for Older People Page 8 of 10 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 9 of 10 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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