Care Home: Hillview Nursing Home

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What the care home does well Hillview provides a homely, safe and friendly place for people to live. People spoke highly of the staff and the care they received. Care staff interviewed clearly enjoyed their work and had good knowledge about the people they were caring for. One person commented in a survey `I think Hillview is an excellent place for anyone who has to go into a care environment`. What has improved since the last inspection? Since the previous inspection a new activities co-ordinator had been employed, as the previous person had retired. She was very well organized and had a plan of activities in place for daily, weekly and monthly events. A world cruise had recently taken place in the home, which involved many staff and people who use the service. The dining room was decorated for each of the five destinations on the cruise and music and dance was provided to compliment the places. One person had been encouraged to take the photographs of the events and has become the `unofficial photographer` in the home. The photographs showed a lot of people enjoying themselves as they were joining in. New documentation had recently been introduced, `managing customers expectations` which encompasses concerns, complaints, suggestions and compliments. The home is also piloting a `patient line`, where people who use the service can telephone using a free phone number, comment on line or complete a form about day to day concerns. This new service is managed by an independent `third party` and the home will be informed if concerns are raised and they will be investigated. There is a designated trainer for two days of the week to ensure all mandatory training is up to date. 85% of staff have achieved NVQ level 2 or above. This is more than the 50% required and is very good. What the care home could do better: To continue with the high standard of care provided to the people who use the service. Key inspection report Care homes for older people Name: Address: Hillview Nursing Home Meadowgate Eston Middlesbrough TS6 9NN     The quality rating for this care home is:   three star excellent 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: Valerie Daly     Date: 0 7 0 9 2 0 0 9 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 26 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 26 Information about the care home Name of care home: Address: Hillview Nursing Home Meadowgate Eston Middlesbrough TS6 9NN 01642440560 01642452438 smitshe@bupa.com www.bupa.co.uk BUPA Care Homes (GL) Ltd care home 53 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 53 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 category: Old age, not falling within any other category, Code OP, maximum number of places 53 Date of last inspection Brief description of the care home Hillview is a care home that provides personal and nursing care to older people. It is a large building in it?s own grounds situated close to the Cleveland Hills. The home has 53 bedrooms on two floors. Fifty-three of the bedrooms are single with 28 of those having en suite facilities. There is one double bedroom. There are a number of lounges for the residents to use along with two spacious dining rooms. The home is accessible from the A174 and through Eston, where there are shops and pubs. The home is owned by BUPA and the Responsible Individual is Lesley Tart. The Registered Manager is Sheila Smith. Care Homes for Older People Page 4 of 26 Over 65 53 0 Brief description of the care home Weekly fees are from four hundred, sixty three pounds and ninety pence to eight hundred, seven pounds and thirteen pence. Care Homes for Older People Page 5 of 26 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: three star excellent 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: The quality rating for this service is three stars. This means people who use this service experience excellent quality outcomes. This key inspection was to check that the home meets the standards that the care Quality Commission say are the most important for the people who use the service, and that it does what the Care Standards regulations say it must. The inspection was conducted by one inspector in two inspection days. During the inspection a number of records were looked at, including records of people who use the service, along with staff recruitment and training records and maintenance. the medication systems were also looked at and discussed with the manager. There was also discussion with the manager and staff who work at Hillview Nursing Care Homes for Older People Page 6 of 26 Home. The manager had completed the Annual Quality Assurance (AQAA), the services selfassessment of how well they think they are meeting the standards. This was received prior to the inspection. We have reviewed our practice when making requirements to improve national consistency. Some regulations from previous reports may have been deleted or carries forward into this report as recommendations, but only when it is considered that the people who use the service are not being put at risk or harm. In future if a requirement is repeated it is likely that enforcement action will be taken. Care Homes for Older People Page 7 of 26 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. 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 8 of 26 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 9 of 26 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 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. Peoples needs were assessed before moving to the home and they were assured those needs would be met. Evidence: The care files of four people were looked at. Two of the files were for people who had recently been admitted to the home. All of the files contained the homes own pre admission assessment and for those people who were being supported with the funding, there was also a copy of the care management assessment. The home continues to use BUPAs Quest assessment documentation, which is very detailed and comprehensive. A person spoken with confirmed that they had been involved in the admission process and had been given sufficient information. Three surveys completed by relatives of people using the service confirmed that they Care Homes for Older People Page 10 of 26 Evidence: were given enough information to help them decide if the home was the right place for their family member. Care Homes for Older People Page 11 of 26 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. 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 health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: Four care files were examined. They each contained individual care plans, which were written in a person centered way. The plans were reviewed and updated regularly with the person themselves or relatives being involved if they wished. There was also a lifestyle plan included, which detailed how the person liked to spend their day, for example, one person preferred to get up between 7am and 8am and have breakfast in bed at 9am, which was cheese on toast and a cup of coffee. A history of each person was in place a map of life and at the time of the inspection the activity co-ordinator was in the process of ensuring as much information as Care Homes for Older People Page 12 of 26 Evidence: possible was included from the person themselves, relatives and friends, where possible. Childhood memories, school, employment, family, holidays and interests were written about. There was information within the care plans to show that peoples health care needs were being met. A person who had completed a survey said The home meets the personal and emotional needs of everyone, it is a warm, friendly and happy place to live. There were policies and procedures in place for the ordering, receipt, storage, disposal and administration of medication. Care Homes for Older People Page 13 of 26 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. 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 who use the services are able to make choices about their lifestyle. There are many opportunities to take part in activities. The food provided is of a good quality and a variety of meals are offered. Evidence: Since the previous inspection a new activities co-ordinator had been employed, as the previous person had retired. She was very well organized and had a plan of activities in place for daily, weekly and monthly events. A world cruise had recently taken place in the home, which involved many staff and people who use the service. The dining room was decorated for each of the five destinations on the cruise and music and dance was provided to compliment the places. One person had been encouraged to take the photographs of the events and has become the unofficial photographer in the home. The photographs showed a lot of people enjoying themselves as they were joining in. Care Homes for Older People Page 14 of 26 Evidence: The activities person is involved in gathering information towards the peoples map of life and said that this gives her a good insight into peoples interests and lifestyle. Each person has their own activity record sheet which is completed when any activitiy is attended. At the end of each session discussion takes place and people enjoy a cup of tea. Popular activities are; movement to music, pampering, art and crafts, bingo, history discussions, poetry, music and films. For those people who cannot or dont wish to join in with the activities, time is made for one to sessions, which may be reading out part of a newspaper or sitting chatting. One person goes into the activity room every morning and enjoys a cup of tea and chat. Entertainment takes place every month and people enjoyed various choirs and individual singers. Relatives spoken to said they are welcome to attend all events. People spoken to said they have a choice about how they like to spend their day. They can also choose what time to get up and go to bed and when they would like to have a shower or bath. The menu showed a variety of food is offered, which is nutritionally balanced. people who use the service are encouraged to be involved in developing the menus. The home also has a Nite Bite menu, which enables people to choose to eat later, if they wish. The manager has recently introduced protected meal times, which ensures that people are not disturbed with medication when they are eating their meal, it is given when they are finished. Lunch was observed. The tables were nicely set with tablecloths and condiments. Care Homes for Older People Page 15 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 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 who use the service are able to express their concerns and have access to a robust, effective complaints procedure, are protected from abuse, and have their rights protected. Evidence: The home has a robust complaints policy and procedure in place. There had been one complaint made to the home since the last inspection. Written records showed that this had been investigated promptly and appropriate action had been taken. Four people who use the service and a relative said they felt they could talk to any member of staff if they had a concern or complaint. New documentation had recently been introduced, managing customers expectations which encompasses concerns, complaints, suggestions and compliments. The home is also piloting a patient line, where people who use the service can telephone using a free phone number, comment on line or complete a form about day to day concerns. This new service is managed by an independent third party and the home will be informed if concerns are raised and they will be investigated. The home has a whistle blowing policy and safeguarding people policy and procedure Care Homes for Older People Page 16 of 26 Evidence: in place. Staff spoken to said they had completed training and a work book for safeguarding people. This was confirmed in the staff training records. Care Homes for Older People Page 17 of 26 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 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 physical design and layout of the home enables people who use the service to live in a safe, well-maintained and comfortable environment. Evidence: A tour of the home was carried out. All areas were well maintained, very clean and odour free. The communal areas were homely and comfortable. People spoken to during the inspection said whilst there were lots of different areas to relax in during the day they were in their own routines and liked to keep to the same lounges. Bedrooms contained personal items depending on what the person wished to bring with them into the home. Since the previous inspection nine bedrooms had been refurbished and two lounge areas. The garden had been landscaped and three pergolas had been built, enabling people to sit out in the garden away from the home if they wished. New garden furniture had also been purchased on the patio area. On the day of the inspection some people were sat outside with their relatives enjoying the sunshine. Further work is to be carried out inside the home, the flooring is to be replaced along one corridor on the ground floor. Care Homes for Older People Page 18 of 26 Evidence: People who use the service also now have access to the internet and a Nintendo Wii has also been purchased and games were enjoyed. Care Homes for Older People Page 19 of 26 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. 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. Evidence: From the rotas in the home, there were sufficient staff on duty to meet the assessed needs of the people who were using the service. People interviewed said that staff were usually around and answered call bells quickly. The home have staff files in place, which provided evidence that the appointment of a new staff member is made through robust recruitment processes. This includes the vetting of staff through the use of references and Criminal Record Bureau (CRB) checks. From the information contained in the AQAA 85 of staff have achieved NVQ level 2 or above. This is more than the 50 required and is very good. The home has a training and development plan in place. There is a designated trainer for two days of the week to ensure all mandatory training is up to date. Three members of staff interviewed confirmed that their mandatory training was up to date. Recent training has also taken place in stroke awareness, safeguarding people, which is from Redcar and Cleveland Council, equality and diversity, infection control and a medication course. One carer interviewed said there is also opportunities to do distance learning, Care Homes for Older People Page 20 of 26 Evidence: for example in palliative care. Clinical forums for qualified staff are also held in the home and staff from other BUPA homes attend. Training is given in areas such as venepuncture, nutrition, Mental Capacity Act and Deprivation of Liberty. People spoken to during the inspection were all positive about the staff, their approach and attitude and how well they felt cared for. One person commented in a survey I think Hillview is an excellent place for anyone who has to go into a care environment. Care Homes for Older People Page 21 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 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 management and administration of the home is based on openness and respect and has effective quality assurance systems. Evidence: The manager is a qualified nurse and has achieved the registered managers award. She has managed the home for a number of years. The home has a number of quality assurance systems in place and since the last inspection more have been introduced. The manager audits all health and safety and maintenance monthly and completes documentation. She also audits four care plans per month and collates information. There are also quality circles which includes: a medication audit, looking at homely Care Homes for Older People Page 22 of 26 Evidence: remedies, management of controlled drugs and as directed and ordering medication. There is documentation to complete regarding any people who have pressure ulcers. A customer service audit is carried out monthly which includes, the environment, peoples bedrooms, the building outside and the gardens. The area manager visits the home at least monthly and carries out a regulation 26 visit. Documentation is audited including, finance, health and safety, reportable incidents, complaints, recruitment, training. He also speaks to people who use the service, relatives and staff. Questionnaires are sent out annually to people who use the service to seek their views about life in the home and the service provided. There are meetings held every three months both for staff and people who use the service. Minutes are kept of the meetings. A number of health and safety documents were examined at the inspection and they were all found to be up to date. Care Homes for Older People Page 23 of 26 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 24 of 26 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 Older People Page 25 of 26 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). 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