Care Home: Hilltop

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What the care home does well The home has a thorough assessment process so that people moving into the home know that their needs will be met. People living at the home are supported to make choices about their life style, to take part in various activities and to keep in contact with friends and family. People have access to a full range of healthcare support as necessary and receive personal support in the way they prefer and according to their needs. Staff are appropriately trained and recruitment procedures offer the people living at the home protection. What has improved since the last inspection? The three outstanding requirements from the last inspection have been met. The home has been carrying out regular testing of the fire alarm system and recording each test in the fire log book. A staff rota has been introduced and the home has now introduced quality assurance questionnaires to seek the views of people living at the home and other stakeholders. The manager has been proactive in making other changes such as improving care plans, keeping policies and procedures under regular review and making improvements to the environment. What the care home could do better: There were no requirements or concerns as a result of this inspection. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Hilltop Peewit Hill, West End Road Bursledon Hampshire SO31 8BP     The quality rating for this care home is:   two star good service 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Chris Johnson     Date: 1 2 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. the things that people have said are important to them: They reflect 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. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Hilltop Peewit Hill, West End Road Bursledon Hampshire SO31 8BP 02380405944 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Jane Strange Type of registration: Number of places registered: Mrs Jane Strange care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 5. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home Hilltop is a family run home, registered to accommodate five adults with a learning disability. The home is situated on the outskirts of Southampton with local shops nearby. Each person has their own bedroom and access to a communal lounge/dining room, large kitchen, conservatory and gardens. The registered provider and her family live on the premises. Following the approval of an application to vary the homes conditions of registration the home has increased the number of people it can accommodate from four to five. The current range of fees is eight hundred and thrirty pounds a week to nine hundred pounds per week. This information was obtained at the Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 5 Brief description of the care home time of the inspection visit. Members of the public may wish to obtain more up to date information from the care home. Care Homes for Adults (18-65 years) Page 5 of 28 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The purpose of this inspection was to assess how well the home is doing in the meeting of all key National Minimum Standards, compliance with regulations, previous requirements and to assess what the outcomes are for people who live at this home. The findings of this report are based on a number of different sources of evidence. These included an unannounced visit to the home, which was carried out over one day on 12th November 2008 whereby we looked at all key standards. Previously to this, we carried out an annual service review of the home on 30th April 2008 and this did not raise any issues of concern. All regulatory activity since the last inspection was reviewed and taken into account including any notifications sent to the Commission for Social Care. The manager completed an Annual Quality Assurance Assessment (AQAA) Care Homes for Adults (18-65 years) Page 6 of 28 prior to the annual service review and this information was taken into account and forms some of the evidence for this report. During this visit we looked at the physical environment including, peoples bedrooms and all communal areas of the home. Staff and care records were inspected. Some members of staff were spoken with and others were observed during their day to day interactions with those living at the home. We examined records, policies and procedures. We spoke with people who live at the home. Due to communication difficulties and the complex needs of the people living at the home the inspector was not able to hold in depth discussions with them. However the inspector was able to talk to people briefly, interact with them and spend time observing the care being given to them. The manager was present throughout the visit to answer questions and discuss issues. 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a thorough assessment process so that people moving into the home know that their needs will be met. Evidence: No one had moved into this home since our last inspection of the home on 19th December 2006. The last inspection of the home did not raise any concerns with this outcome area. At that inspection it was found that, The home has assessed the needs of its current service users well. These are clearly recorded and known to staff. Since our last visit to the home they have extended the premises and have created room for one more person. At the time of this visit the home had not as yet filled this bed space. The AQAA provided evidence that an assessment process continues to be in place and the home sent us copy of the updated Statement of Purpose to reflect changes in numbers. The manager confirmed that the admission process had not changed since the last Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: inspection and was able to demonstrate that she was aware of the importance of making sure that she could meet peoples needs before offering them a place at the home. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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. Each person has an individual care plan that details his or her support needs. People can make their own decisions about their lives. Evidence: The last time that we inspected this home we found that, The home has a good care planning regime, which involves service users, and which addresses identified personal, social and health care needs. The annual service review carried out on 30th April 2008 did not raise any concerns in this outcome area. A survey sent to us by a healthcare professional at the time of the annual service review professional told us that the home responded to different needs and that people were supported to live the life they choose. The AQAA provided evidence that the home continues to keep peoples needs under review and stated that the care plan format had been changed. The manager stated in Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: the AQAA that the reason for this was, So that it is more user friendly. During this visit to the home we examined the care plans of two people. These were detailed and were integrated with risk assessments and risk management plans. Both peoples care plans had been reviewed at regular intervals or as and when a change in their support needs had occurred. The manager explained they were still developing the care plans and we saw examples of both the new style care plans and the older style plans. The manager had recently employed an experienced care worker on a temporary basis to assist her in the process of improving the care plan format. Information and guidance within the care plans showed that consideration had been given to respecting and maintaining peoples choices with regard to their care and everyday living support needs. The care plans seen covered areas such as support with mobility, any assistance aids used and associated risks, support with personal care such as showering and dressing, and how people were encouraged and supported to make choices and maintain independence with these tasks. Where necessary there were guidelines for supporting people throughout the day and night. Where specific risks had been identified there were detailed guidelines for staff as to detailing how they should manage these risk and what action to take in specific circumstances including key phrases to use. Staff who completed a survey told us that they were given up to date information about the needs of the people living at the home. One person commented, Anything that has happened or changed is handed over by the manager each day. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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 living at the home are able to make choices about their life style, and are supported to develop life skills. People are supported to engage in activities and to keep in contact with friends and family. Evidence: The AQAA told us that people continued to be supported to access the community and that they were hoping to assist people to use public transport by getting bus passes to gain more independence. It also stated that menus had been tailored to include personal preferences. We confirmed through information recorded in care plans and other records held at the home such as daily records that people do engage in a variety of activities of their own choosing. Evidence was seen that each person does different things according to their Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: needs and preferences and in a manner that is suited to their needs. We saw evidence that people living at the home are offered a balanced and healthy menu. Meals are chosen based on individual likes and healthcare needs. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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. People are fully supported with their healthcare needs. Evidence: The healthcare records for two people were examined during our visit to the home. Records demonstrated that the home liaises with outside professionals and other agencies as appropriate and that people had access to a range of healthcare services such as GPs, opticians, dentists and specialist healthcare teams. We saw evidence that peoples healthcare support needs are monitored and that people are supported to attend appointments as necessary. We received completed surveys from health and social care professionals in April 2008 as part of the annual service review and again for this inspection. On both occasions comments were positive with regard to the level of healthcare support that the home offers people. On both occasions all respondents said that they considered that the home met peoples healthcare needs and that they liaised appropriately with other services and respected people privacy and dignity. One healthcare professional commented,The manager and staff meet the care needs and evaluate needs. They Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: will approach appropriate persons on behalf of service users if additional support is required. IE refer to community LD team. During the visit to the home we examined the medication records of three people. Records had been maintained appropriately and these were checked against stock held at the home and found to be accurate. Storage facilities were safe and secure. One person regularly takes a lunchtime dose of medication to day services with them. We discussed with the manager the need to keep a record of medication leaving the home for these purposes so that the home has a clear audit trail of all medicines received into the home. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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. Satisfactory systems are in place for people to address any concerns or complaints that they may have. Procedures are in place to offer them protection. Evidence: No complaints regarding the home have been reported to the Commission for Social Care Inspection since the last inspection. Data in the AQAA told us that the home had not received any complaints in the last twelve months and examination of the homes complaint log supported this. Health and social care professionals who returned a survey told us that the home always dealt with any concerns that they may have and people living at the home who returned a survey all said that they knew who to speak to if they were unhappy. People When we looked at the files of people living at the home we saw recorded evidence that the homes complaints procedure had been explained to them and that where applicable this had been supplied to people in audio format. Staff reported that they were aware of the procedures to follow in the event of someone wishing to make a complaint. From the inspection of staff training files we saw that staff receive training in protecting people from abuse. Care Homes for Adults (18-65 years) Page 18 of 28 Care Homes for Adults (18-65 years) Page 19 of 28 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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 live in a safe homely and comfortable environment. The home is kept clean and has procedures for the maintenance of infection control. Evidence: We looked at all areas of the home during our visit including some bedrooms. The home was found to be clean and tidy and homely. From observation people were relaxed and at home in their environment and were able to pursue their own leisure interests as they chose. People had been able to personalise their own rooms with pictures, belongings, televisions and audio equipment. The AQAA provided evidence that the home continues to maintain and improve the environment such as the new utility room and that furnishings are regularly replaced. It also confirmed that systems are in place to maintain infection control and that there are further plans for improvements to the environment in the future. We carried out a site visit to the home on the 17th January 2008 following the submission of an application to vary the homes conditions. During this visit we identified some areas that needed to be improved prior to agreeing the variation. We received confirmation from the home that these were done. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: While looking at peoples bedrooms we noted that there were some issues requiring attention such as knobs missing from drawers. The manager agreed to rectify these straight away as there were screws protruding that could harm someone. It was suggested that the home should introduce a regular audit system for the environment so that issues are quickly identified. Care Homes for Adults (18-65 years) Page 21 of 28 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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 employed in sufficient numbers to meet the needs of people living at the home. They are well trained and undergo a thorough recruitment process. Evidence: During the visit to the home we looked at the staff rota. At the last inspection of the home it was found that the home had not been keeping an up to date rota of who had worked in the home and a requirement was made. This had been addressed and from examination of the rota it proved to be a true reflection of actual staffing levels. The only issue discussed with the manager was the need to date the rota so that a clear record is maintained of who worked on any particular date. The manager agreed to do this. On the day of the visit one staff member had phoned in sick and the manager was providing cover in their absence. An additional staff member was brought in during the day to enable the manager to spend time with the inspector. We saw evidence that staffing levels remain constant and are maintained at the same level as at previous inspections. Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: From the information supplied in the AQAA, examination of staff files and discussion with staff it was evident that the home provides training and development opportunities to staff which is relevant to their work. We saw evidence that new staff had undertaken skills for care linked induction training and a basic induction into the home. In discussion with one staff member they described their induction and told us that they considered it to be thorough and that it had prepared them adequately to support the people living at the home. The recruitment records of three members of staff who had been employed by the home since the last inspection were examined. These demonstrated that the home follows procedures and carries out all relevant checks on staff prior to recruitment. This was supported by evidence supplied in the AQAA and was consistent with the findings of previous inspections. Staff told us that they felt supported by the manager and we saw evidence that they receive regular supervision. Responses to surveys returned by health and social care professionals told us that they considered that staff usually had the right skills and experience to meet peoples needs. One person commented that, the manager will access additional support from the community team if they require extra advice or support. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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. The home is well managed. The manager is accessible and sensitive to the needs of those living at the home. The home is well maintained and equipment is serviced to keep everyone safe. Evidence: At the last inspection of the home three requirements were made regarding some aspects of record keeping and quality assurance. We know from information recorded in the AQAA that quality assurance questionnaires have now been introduced and that the fire log is completed weekly. Examination of the fire logbook during our visit demonstrated that regular and thorough testing and servicing of the homes fire detection and fire fighting equipment was being carried out. Since the last inspection of the home the manager has completed a registered managers award. Information sent to us in the AQAA that had been completed by the manager proved to be an accurate reflection of the service. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: The annual service review carried out in April 2008 did not raise any concerns regarding the management of this home. Data from the AQAA provided sufficient information to show that policies and procedures are kept under regular review and that the home continues to plan and make improvements. It also provided evidence that equipment in the home is maintained and serviced at regular intervals. Evidence seen during the visit substantiated this. There were not any concerns with regard to safety within the home environment as a result of this inspection. Information sent to us in the AQAA that had been completed by the manager proved to be an accurate reflection of the service. Data recorded in the AQAA told us that policies and procedures are kept under regular review and examination of a sample of these confirmed this. The AQAA also gave details and evidence that maintenance checks, tests and servicing of equipment are carried out on a regular basis evidence seen during the visit substantiated this. Examination of the fire logbook demonstrated that regular and thorough testing and servicing of the homes fire detection and fire-fighting equipment was being carried out and other appliances as appropriate. There were not any concerns with regard to safety within the home environment. Care Homes for Adults (18-65 years) Page 25 of 28 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 Adults (18-65 years) Page 26 of 28 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 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 Adults (18-65 years) Page 27 of 28 Helpline: 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 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 © (2008) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - 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!