Care Home: Hilltop House

Annual service review Name of Service: Hilltop House The quality rating for this care home is: The rating was made on: three star excellent service 2 2 0 1 2 0 0 9 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 We do an annual service review when there has been no key inspection of the service in the last 12 months. It does not involve a visit to the service but is a summary of new information given to us, or collected by us, since the last key inspection or annual service review.   Has this annual service review changed our opinion of the service?   No You should read the last key inspection report for this service to get a full picture of how well outcomes for the people using the service are being met. The date by which we will do a key inspection: Name of inspector: Rajshree Mistry Date of this annual service review: 3 1 1 2 2 0 0 9 Annual Service Review Page 1 of 8 Information about the service Address of service: Ashton Road Hartwell Northampton Northamptonshire NN7 2EY 01604864466 01604864466 kathy.swannell@oakleafcare.com Telephone number: Fax number: Email address: Provider web address:   Name of registered provider(s): Conditions of registration: Category(ies) : mental disorder, excluding learning disability or dementia physical disability Conditions of registration: Oakleaf Care (Hartwell) Ltd Number of places (if applicable): Under 65 Over 65 28 28 0 0 The maximum number of service users who can be accommodated is: 28 The registered person may provide the following categories of service only: Care home with nursing - Code N To service users of the following gender: Either Whose primary care need on admission to the home are within the following categories: Mental Disorder - Code MD Physical Disability - Code PD Have there been any changes in the ownership, management or the No service’s registration details in the last 12 months? If yes, what have they been: Date of last key inspection: Date of last annual service review (if applicable): Brief description of the service Hilltop House is a service for people with acquired brain injury and associated disorders. It opened in 2005 and is situated in a converted manor house on the outskirts of the village of Hartwell in rural Northamptonshire. It provides personal care and nursing to younger adults. 2 2 0 1 2 0 0 9 Annual Service Review Page 2 of 8 The accommodation is in either the House (nine beds), the Lodge (10 beds), or in one of the four flats designed for semi-independent living. All the bedrooms are single with en-suite facilities. The communal lounges and dining areas in both the House and the Lodge is spacious. Hilltop House is set in extensive grounds with activities rooms, an indoor hot tub, gym, mini golf course, summerhouse, lawns and paddocks, and a secure garden area. The fees for 2009/10 are not known. People who are interested in using Hilltop House should contact the Registered Manager or the home directly for the range of fees. Further information about Hilltop House can be obtained from the home in the form of the Service User Guide and the Statement of Purpose. The latest Inspection Reports are available at the home or can be accessed via the Care Quality Commission (CQC) website: www.cqc.org.uk Annual Service Review Page 3 of 8 Service update since the last key inspection or annual service review: What did we do for this annual service review? We looked at all the information that we have received or asked for since the last key inspection. This included the Annual Quality Assurance Assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for the people using the service. It also gave us some numerical information about the service. We assessed the information we have about the service and how the complaints received have been managed. We looked at what the service has told us with regards to the things that have happened in the service. These are called notifications and are a legal requirement. We looked at the last Key Inspection report dated 22nd January 2009 and the results of any other visits that we have made to the service in the last 12 months. We looked at the relevant information from other organisations and what other people have told us about the service. We sent out surveys to the people using the service, the staff working at the home and the stakeholders that financially support the people using the service such as the local authority. What has this told us about the service? Hilltop House sent to us their Annual Quality Assurance Assessment (AQAA) when we asked for it. It was clear and gave us all the information we asked for. We looked at the information in the AQAA and our judgement is that the home is still providing an excellent service. Hilltop House has demonstrated how it continues to maintain the standards of care and meet the needs of the people who use the service. The AQAA was completed by the Registered Manager and provided details of what the service does well and the evidence to support the practice within the service. The AQAA demonstrated that there is a pre-admission assessment of needs process. This is to ensure individual needs can be met by the home and Hilltop House is the right place for them. The assessment of needs process involves other health and social care professionals, known as multi-disciplinary team to ensure needs will be met safely with the provision of specialist aids, adaptations and expertise. The AQAA details the improvements made that include the new website for the service, the new admission assessment form, the new weekly admission meeting and the new generic goals. This shows the service recognises the importance to continuing to improve the service and communication between staff and professionals to benefit the Annual Service Review Page 4 of 8 people who live at the home. The AQAA states people who use the service have rehabilitations sessions and are supported by specialist nurses to aid their rehabilitation and recovery. Care plans are developed with individuals and involving the multi-disciplinary team to ensure the care and support needs are met. Assessments of risk are completed and safety measures with guidance for staff are detailed in the care plans to promote peoples well-being and progressive independence. The AQAA states there are are regular meetings to monitor and review individual progress. The improvements made to the quality of service people receive includes increased therapy from the Speech and Language Team (SALT) and Psychologist; new audits on the home environment and the quality of care, and music therapy following requests made by the family of the people who use the service. The people who use the service benefit from a team of therapists and therapy sessions reflective of daily living skills, interests and aspirations. People are supported to make decisions and take part in a range of social and leisure activities. People maintain contact with family and friends, which promotes a better quality of life. Individual interests are detailed in the care plans for staff to support people as part of their rehabilitations. The improvements made with regards to peoples lifestyle at the home include the introduction of a buddy systems, to support people with specific interests including culture. The home has purchased activity equipment since the activity committee was set up. New wheelchair scales have also been purchased following the last Key Inspection of the service. The horse-riding sessions have been re-introduced and there are plans to start yoga and holistic therapy in the future. The AQAA states people are encouraged to be as independent as possible and are supported to manage their own personal care. Care plans provide staff with guidance to give people appropriate levels of support that promotes their safety, well-being and independence. Hilltop House works well with other health and social care professionals to meet peoples health care needs. People have access to health services ranging from the General Practitioner, Dentist, Dietician and the Practice Nurse, who also provides staff with information and training. The improvements made to promote peoples health includes the increased hours of support from the neuro-psychology clinic and the new health care monitoring forms for reviews. Staff have also received external training including: abdominal massage, HIV/Hep B, diabetes, tissue viability, venepuncture, oxygen use, death/dying policy and training, Deprivation of Libertys and Mental Capacity training. The AQAA states the complaints procedure is in place and provided to people who live at the home. The complaint procedure clearly sets out the process and includes the contact details for Advocacy Services. The numerical information in the AQAA states Hilltop House received 1 complaint, which was resolved within the set timescales and was substantiated. Annual Service Review Page 5 of 8 The AQAA states the home made 2 safeguarding referrals to the local authority in line with the multi-agency procedure. Safeguarding means the protecting and promoting the well-being of people who use the service from risk, harm and abuse. The Care Quality Commission did receive information from a Care Manager from a local authority relating to a person using the service, which they raised directly with the Registered Manager. We have received no other expressions of concerns or complaints. Hilltop House submits to the Care Quality Commission, timely notifications, known as Regulation 37 notifications. It has details of events, incidents and accidents that affect the well-being of people who use the service. This is a legal requirement and the home is compliant. Hilltop House is an established service, providing a range of accommodation to suit peoples needs. The House and the Lodge provides the main accommodation for people at the home. There are also four flats for semi-independent living. The AQAA states people are encouraged to choose the decor to make their private bedroom homely and comfortable. There are a range of aids, equipment and adaptations to support and promote peoples health, safety and independence. The improvements made to the home include new decoration, new linen has been purchased, new carpets and new mattresses. The home is now using an external agency for carpet cleaning. A member of staff is in the process of completing the NEBOSH training, with regards to health and safety. The AQAA demonstrates staff recruitment is robust. The staff are required to complete induction training, mandatory training and awareness training to support the people who use the service. Staff have regular staff meetings and supervisions. The home has been awarded the Team of the Year - Caring Times. The Registered Manager and staff have attended external management and self-awareness training. The Registered Manager and another member of staff have completed the Mental Capacity Training for Trainers, the number of staff that have attained National Vocational Qualification (NVQ) level 2 in care has increased and there are now 2 NAPPI instructors within the home to ensure staff skills and practice is maintained. The Registered Manager is a Registered Mental Health Nurse (RMN), has substantial experience of working with people with acquired brain injury and has good leadership qualities. The management team has increased with the appointment of the Deputy General Manager and the Nurse Manager. There are clear roles and responsibilities for the management and staff team. Trained staff are deployed and people who use the service benefit from having an increased level of staffing that supports and promote peoples well-being and interests. The AQAA details all the policies and procedures that are in place, which were last reviewed in August 2009. The details of the maintenance, servicing and testing of equipment in the home is recorded. This includes the electrical tests, hoists, fire safety, heating and lighting. This shows Hilltop House complies with other regulations and maintains a safe environment for all. We sent out 22 surveys to the people who use the service and 87 staff surveys, of which none were returned. We also sent out surveys to the General Practitioner and Annual Service Review Page 6 of 8 the Care Management Team responsible for financially supporting the people who use the service. We did receive 1 survey but this was not completed. Therefore, we were unable to ascertain the views and experiences of the people who use the service, staff that work at the home and organisations that financially support people. Hilltop House continues to let us know about the things that have happened since the last Key Inspection. They have shown that they have managed issues and maintained the quality of the service and the home environment. They work well with us and have shown that the service continues to provide excellent outcomes for the people who use it. What are we going to do as a result of this annual service review? The next inspection of this service will be based on the Fees and Frequency Regulations 2007 and the assessment of risk of the service. Further clarity will become evident as the new registration and inspection system under the Health and Social Care Act 2008 is confirmed. Annual Service Review Page 7 of 8 Reader Information Document Purpose: Author: Audience: Further copies from: Annual service review CQC General Public 0870 240 7535 (national contact centre) Our duty to regulate social care services is set out in the Care Standards Act 2000. The content of which can be found on our website. 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