Care Home: Hydon Hill Cheshire Home

What the care home does well The home is well managed. It has a good organisational structure that means all staff are clear about their roles and responsibilities. Staffing levels and staff training at the home are very good. The home supports the residents to make informed choices and to lead active and fulfilling lives. The home positively promotes the independence of the residents. There are lots of opportunities to take part in stimulating activities both within the home and the local community. The residents are treated with a great deal of respect and their privacy and dignity are preserved. The home actively promotes their health and wellbeing. There are comprehensive care plans that promote individualised health and personal care for the residents. There is a well-trained and committed staff team who promote the residents` independence. There is a great deal of specialist input into the home. It has it`s own physiotherapy department and employs a full time Chartered Physiotherapist and assistants. There is regular input form other health and social care professionals such as speech and language therapists, occupational therapist and dieticians. There is a very pleasant and welcoming environment. The accommodation is well maintained and, despite it`s size, it is homely. What has improved since the last inspection? There have been increased activities in the home. in particular, more going on in the " bar" area in the evenings. The number of opportunities for social outings has been increased to five times each week. The advice of a consultant neurologist has been sought and appropriate referrals have been made. Whilst the home is in a rather isolated position and this has made staff recruitment difficult there have been improvements in the way the home recruit and manages staff. They have also recognised that agency staff need clearer and more concise direction and developed innovative ways of ensuring information is communicated well and quickly. What the care home could do better: The home would benefit from more attention to detail in the way the day-today environment is maintained. For example, a better system for checking bathrooms and toilets to ensure they are always in a fit state and a review of the way items such as bath mats and bath cushions are stored, would greatly improve the environment. It is recommended that the registered manager or the acting manager, make a daily tour of the home to ensure standards are maintained. CARE HOME ADULTS 18-65 Hydon Hill Cheshire Home Clock Barn Lane Godalming Surrey GU8 4BA Lead Inspector Wendy Mills Unannounced Inspection 31st October 2007 09:30 Hydon Hill Cheshire Home DS0000017618.V346523.R01.S.doc Version 5.2 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Hydon Hill Cheshire Home DS0000017618.V346523.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Hydon Hill Cheshire Home DS0000017618.V346523.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hydon Hill Cheshire Home Address Clock Barn Lane Godalming Surrey GU8 4BA 01483 860516 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) hydon@south.leonard-cheshire.org.uk www.leonard-cheshire.org.uk Leonard Cheshire Mrs Janet Taylor Care Home 43 Category(ies) of Physical disability (33), Physical disability over registration, with number 65 years of age (10) of places Hydon Hill Cheshire Home DS0000017618.V346523.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Thirteen (13) places may be used for the provision of personal care only. Ten (10) places may fall within the category of Physical Disability (over the age of 65 years) PD(E). 23rd July 2002 Date of last inspection Brief Description of the Service: Hydon Hill is a care home providing both residential and nursing care for up to forty-three people with profound physical disabilities and significant nursing needs. The accommodation is provided in a large, purpose built, single story building and a bungalow with accommodation for two people. The home is located in several acres of woodland approximately two miles south of the Surrey town of Godalming. The home is in a rather isolated position and public transport access is limited, however, there is plenty of room to park on site. All residents’ rooms in the main building have access through patio doors to the grounds of the home. Some residents have had conservatories built on to their rooms to extend their accommodation and independence. All the residents are wheelchair users and all areas of the home are easily accessible by wheelchair. The communal areas are very spacious and include a large dining room, a large association area where there is plenty of room for wheelchairs and comfortable chairs, an activities room, a computer room, a bar and a mini cinema. In addition there is a well-equipped physiotherapy department. The corridors are very wide and allow passage for both manual and electric wheelchairs in both directions. The grounds of the home are spacious, well maintained and very attractive. There is a great deal of local wildlife and this gives great enjoyment to many of the residents. The weekly fees for this home range between £910 and £1431 and are based on the assessed needs of individual residents. Hydon Hill Cheshire Home DS0000017618.V346523.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was unannounced. It formed part of the inspection process of the Commission for Social Care Inspection (CSCI) under the Regulations of the Care Standards Act 2000. This report has been compiled using information gained during this visit and information supplied prior to the visit from a variety of sources including the Home’s own quality document, the CSCI’s required Annual Quality Assurance Assessment (AQAA), and feedback from relatives, visiting health and social care professionals and supporters of the home. During the visit residents and staff were spoken to both in private and during a tour of the home. In-depth discussion was held with residents, the acting manager and senior nursing and care staff and members of the care and support staff, including volunteers and the volunteer co-ordinator. A tour of the home was made and documentation, including staff files and care plans, was examined. Both direct and indirect observation was used throughout the visit. The home meets the National Minimum Standards well. Residents say that they like living in the home and have interesting lives. They praised the organisation of the home and the way they are cared for. The residents, staff and acting manager are thanked for the welcome they gave and their help throughout this visit. What the service does well: The home is well managed. It has a good organisational structure that means all staff are clear about their roles and responsibilities. Staffing levels and staff training at the home are very good. The home supports the residents to make informed choices and to lead active and fulfilling lives. The home positively promotes the independence of the residents. There are lots of opportunities to take part in stimulating activities both within the home and the local community. The residents are treated with a great deal of respect and their privacy and dignity are preserved. The home actively promotes their health and wellbeing. There are comprehensive care plans that promote individualised health and personal care for the residents. Hydon Hill Cheshire Home DS0000017618.V346523.R01.S.doc Version 5.2 Page 6 There is a well-trained and committed staff team who promote the residents’ independence. There is a great deal of specialist input into the home. It has it’s own physiotherapy department and employs a full time Chartered Physiotherapist and assistants. There is regular input form other health and social care professionals such as speech and language therapists, occupational therapist and dieticians. There is a very pleasant and welcoming environment. The accommodation is well maintained and, despite it’s size, it is homely. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Hydon Hill Cheshire Home DS0000017618.V346523.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hydon Hill Cheshire Home DS0000017618.V346523.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides the residents, their relatives and supporters, with the information they need in order to make a decision about moving into the home. Appropriate pre-admission assessments are made. This ensures that only those residents who are suited to the home and whose needs can be met are admitted to the home. EVIDENCE: There is plenty of easily accessible information about the home. Notice boards are situated in convenient places around the home. A variety of information is displayed, including forthcoming activities and requests for information and volunteer support. On the day of this visit there were posters telling of the planned events for the next week, including a Halloween party and pumpkin hunt. All information is in easy to read and understand formats. The home produces a regular newsletter. The statement of purpose and service user guide contain required information in line with regulations. Hydon Hill Cheshire Home DS0000017618.V346523.R01.S.doc Version 5.2 Page 9 Residents said that they are kept well informed about events happening in the home and that they were given good opportunities to find out about the home before making a decision to move there. Some residents had moved from another Cheshire home that closed. They said that they are pleased with the move and that the home meets their needs. The care plans of the most recently admitted residents were examined. There was good evidence that all appropriate pre-admission assessments and procedures had been carried out. Residents confirmed this. Those residents who were able had signed entries in their care plans. Hydon Hill Cheshire Home DS0000017618.V346523.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home supports the residents to make informed choices. This helps them maximise their independence EVIDENCE: Care plans were examined in detail and three care plans were tracked through to residents’ views and daily records, including medication administration records (MARs). Both nursing and non-nursing residents’ records were examined. Care plans are comprehensive and contain pen pictures of individual residents. Those residents who have written their life histories have signed these entries. Others have chosen not to add to this section of their care plans. There is good evidence that residents have contributed appropriately to their own care plans. Hydon Hill Cheshire Home DS0000017618.V346523.R01.S.doc Version 5.2 Page 11 Conversation with residents confirmed that they contribute to their care plans and are consulted. All residents spoken to were very positive about the home and the way staff consult them. One said, “The staff here are very good, a lot of us have a lot of specialist needs and they all understand what they should do for us”. Residents said that they can choose how they spend their time and that there is plenty to choose from. Risk assessments are in place both for the environment and individual activities. Hydon Hill Cheshire Home DS0000017618.V346523.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are supported to live busy and interesting lives. There is a wide variety of choice of activities both within the home and the local community. This means that residents can maintain as much independence as possible and lead fulfilling lives. EVIDENCE: There was a lot of information about activities available at a number of points throughout the home. On the day of this visit the acting manager gave a short presentation about the new logo that the Cheshire Homes are adopting. There was a game of “Deal or No Deal”, in the morning and giant scrabble game in the afternoon as well as a large number of individual activities. The home has a large arts and crafts room and residents are able to carry out a variety of activities from carpentry to painting in this area. On the day of this visit several residents were using this area. Some were painting, some Hydon Hill Cheshire Home DS0000017618.V346523.R01.S.doc Version 5.2 Page 13 making mini pottery pumpkins for a Halloween pumpkin hunt and a party the following day. There is a volunteer co-coordinator. Several volunteers support residents in their arts and craft activities. There is also a head of activity. Care staff also join in to support activities. Residents said that there is always plenty to do and that they can choose whether to take part or not. There is a very well equipped computer room with Internet access. This has helped residents keep in touch with family and friends. The home also has it’s own bar that opens in the evenings. There is a “cinema” - a room with a large screen TV and a very good supply of films. There are also plenty of boxed games, videos and books all around the home. Some residents like to spend time in their rooms either with their newspapers, books, music or television. The home produces a regular newsletter to let residents and visitors know what is going on and regular residents meetings. Activity records are well maintained and residents said that they have the support they need to carry out their activities. Wheelchairs are very well maintained and the environment is very spacious so that the residents can move freely around the home. The grounds are accessible and well maintained. One resident was enjoying the last of the autumn sunshine for much of the day. Some residents said that they enjoy gardening. There are good opportunities for residents to practice their religions. On Sundays volunteer drivers and the home’s transport are used to take residents who wish, to their various religious services. Local religious groups also visit the home if requested. Visiting times are flexible. There is a residents’ committee that discusses ideas for activities as well as other issues about the home. Some residents take part in fund raising activities. There are other activities within the community such as fetes and sports days that help raise the profile of the home. Despite its isolation, there are plenty of trips into the community, for shopping, theatre trips, and other activities. The home has its own transport and also uses volunteer drivers. Some comments from residents were; “I love it here”; “I can be as independent as I like”; “The staff help me but only in the way I want”; and “ I have a much better life that I did in my last few years at home because I feel in control here and everything is done to help me stay independent”. Hydon Hill Cheshire Home DS0000017618.V346523.R01.S.doc Version 5.2 Page 14 The kitchen is well organised and there is a very large and airy dining area. Lunchtime runs on “restaurant times”. This means that residents can choose when to take lunch during a two-hour period. Residents were very positive about the food. There is always a choice of menu and a vegetarian option. Vegan meals are planned individually with the chef. There were plenty of healthy options noted on the day of this visit, including cauliflower cheese and fresh fruit salad. There was a very wide selection of sauces on the dining tables. The home offers a cooked breakfast on three days a week. On other days there is a good selection of cereals, croissants, porridge, fruit juices and toast. There is always a “warm” supper choice, for example, baked potato, cheese on toast or beans on toast. The kitchen also produces “night boxes” – boxes of sandwiches and snacks in case any resident gets hungry later on in the evening or night. Nutrition is well monitored and staff show a good understanding of the importance of nutrition and individual needs. The acting manager has recently developed a system to ensure any agency staff understand individual nutritional and eating needs – she has made individual place mats that have been laminated. On one side it has the resident’s name but underneath the resident’s eating and nutritional requirements are noted in a discreet and simple way. Indirect observation showed that staff give assistance with feeding in an expert and discrete manner. Many residents have very complex nutritional and feeding needs. Food supplements are used as needed. Residnets said that they have plenty to eat and that the food is, “Very good”. One said, “We have a very good chef who looks after all our needs, I’ve no complaints about the food”. The care plans note residents’ choices and preferences about all aspects of their daily life, including when they like to get up, how they wish to be supported with their personal care and their hobbies and interests. Hydon Hill Cheshire Home DS0000017618.V346523.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 & 21 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home promotes the health and well-being of the residents and treats them with respect. This means that they can remain as healthy as possible and that their privacy and dignity is preserved. EVIDENCE: Care plans are comprehensive, in good order and well used. They show that health and social care appointments are made and kept appropriately. The care plans detail the way in which personal care should be offered and carried out. The residents said that they had been able to input into this section. They also said that they could choose to change them, for example they can choose to take a bath rather than a shower, ask for a carer of a specific gender and get up when they please. Since the last inspection the home has arranged for a neurologist to visit. He has carried out a number of assessments and referred some of the residents on to other consultants to see if they can be helped by new techniques. Hydon Hill Cheshire Home DS0000017618.V346523.R01.S.doc Version 5.2 Page 16 Nutritional and pressure sore assessments are in place. There are wellmaintained records of weight, food and fluid intake and other nutritional requirements. There is a large physiotherapy room and a chartered physiotherapist is employed full time. There are also two physiotherapy assistants. The Chartered Physiotherapist said that there is good team working throughout the home. The physiotherapist and staff are vigilant in ensuring that wheelchairs are regularly serviced and well maintained. The home is very well equipped with moving and handling equipment. Staff were noted to be using this equipment well. The physiotherapist has a large input into moving and handling training. Nearly all the residents have very complex care needs. There was good evidence in the staff files and from conversation with staff, that necessary specialist training is going on. Many care staff have recently attended training in disability and equality. Residents are registered with local dentists and General practices (GPs). They have as much choice as possible in respect of choice about the GPs with whom they are registered. Medication is stored appropriately. The MAR sheets sampled were all in order and had no unexplained omissions. Some residents partially self-medicate but none fully self medicates. Registered General Nurses (RGNs) give medication to those residents who require nursing intervention and care staff give it to those who have residential and care needs. Senior care staff said that they received, “loads of training and support”, to enable them to administer medicines safely. The home aims to support residents for as long as they can meet their needs. Appropriate records of wishes of residents, recognising that there may coma a time when they are unable to make decisions for themselves. Staff training and care practice in the home is good and the home covers all areas of care, including end of life issues. Hydon Hill Cheshire Home DS0000017618.V346523.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are sound policies and procedures for managing concerns and complaints and for protecting vulnerable adults from harm. The staff are clear in their understanding of these. In as far as possible, this protects the residents from all forms of abuse. EVIDENCE: There has been only one formal complaint since the last inspection. The home has kept the CSCI and all other agencies informed about this. The home followed the correct procedure, took appropriate action and learned lessons from the complaint. There are now stricter procedures in place for staff monitoring. Staff said that they always report a colleague if they thought they were guilty of any form of abuse. Staff files show that staff have recently attended Protection of Vulnerable Adults (POVA) training. Staff were clear in their understanding of POVA, in particular they understood specific implications when dealing with profound disability, for example, the importance of communicating well with residents who have little or no speech but good understanding, without belittling or ignoring them; ensuring electric wheelchairs are charged so that residents are not left without mobility and the importance of helping those who need feeding in a sympathetic and skilled way. Hydon Hill Cheshire Home DS0000017618.V346523.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment is good and meets the needs of the residents. It gives them freedom of movement and supports their independence. A redecoration programme and upgrading of the bathroom and toilet areas would give a more homely feel. EVIDENCE: The home is a spacious, single story building with wide corridors. There is a large communal dining room that is clean, airy and spacious. There is an open-plan reception and sitting space and activities areas with computer and cinema rooms. There is excellent accessibility for all residents. The grounds are well maintained and the tarmac pathways, with low gradients, give good access to all areas of the gardens. Residents spoke very enthusiastically about the ease of access they have throughout the home and the grounds. They said that they “felt really at home here”. Hydon Hill Cheshire Home DS0000017618.V346523.R01.S.doc Version 5.2 Page 19 One resident said that she particularly enjoys the freedom this gives her. Another said that he loves to spend as much time as possible in the garden where there is lots of wildlife. There are plenty of assisted bathrooms and toilets with a variety of moving and handling aids ranging from grip rails to overhead electric hoists. The needs of each resident can be met in at least one of these areas. Although all the bathrooms, shower rooms and toilet areas meet standards, they all have a somewhat clinical appearance. Efforts have been made to make them more homely, but even this decor is rather dated. Improvements could be made if more attention was paid to detail in terms of deep cleaning, tidying and redecorating. The acting manager said that she would ensure improvements would be made and work had started on this before the end of this visit. Residents have been able to personalise their rooms, some have even had conservatories built. All rooms have access to the outside through French doors. Corridors are decorated with pictures and some with works produced by residents. The décor in these areas is now looking a bit tired and scuffed. The area would now benefit from a redecoration project. The laundry is situated in a separate building a short distance away from the main home. It is well organised and staff comply with infection control measures. Although the home is large, the opportunities for independent movement around the home outweigh any concerns in this respect. Residents were clear that their quality of life is good and that they have great freedom of choice and movement. Hydon Hill Cheshire Home DS0000017618.V346523.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35 & 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff training, staffing levels and recruitment practices are all good. This means that the residents are cared for by a committed and knowledgeable staff team. The isolation of the home can present recruitment problems and the home sometimes needs to use agency staff. Every effort is made to ensure that agency staff are given clear direction and are familiar with the needs of the residents. EVIDENCE: Rosters show an adequate number of staff on duty and there are a good number of ancillary staff such as cleaners, laundry assistants and chef. There are qualified nurses employed to oversee the care of those residents with nursing needs. A Chartered Physiotherapist and physiotherapy assistants are employed as well as a volunteer co-ordinator and an activities manager. Staffing structures are well-organised and staff are clear about their roles and responsibilities. Hydon Hill Cheshire Home DS0000017618.V346523.R01.S.doc Version 5.2 Page 21 Staff said that there is good team working. One said, “ I know there’s always someone I can ask”. Another said, “The organisation and managers are very supportive - We really work as a team”. A sample of staff files was examined. All showed that all appropriate checks are made prior to offering employment at the home. Recruitment practice is very good. Residents are included in all aspects of this process and four residents have been on a training course in recruitment practice. All staff spoken to say that they get good training. One said, “There’s just loads of it. I feel so lucky that they pay for me to go on courses”. The manager said that there is a system for funding applications. Only relevant courses, that have been identified at one-to-one supervision, are funded by the organisation The home is adequately funded in respect of staffing levels and is able to use agency staff. This can present problems as agency staff may not know and understand the very specific and significant needs of the resiednts. However, the acting manager has worked closely with agencies and has now identified a good local agency that supplies regular staff to the home. Discussion with the senior nurse and the acting manager and feedback from staff showed that the main problem the home faces is recruiting staff in an isolated area. There is regular one-to-one supervision and an organisational structure that facilitates this. There are regular staff meetings. The home is very well supported y a team of volunteers who support the work in a number of aspects of the home from supporting arts and crafts work to maintaining the grounds. The home is always looking for more volunteers. Hydon Hill Cheshire Home DS0000017618.V346523.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run in the best interests of the residents. Their views are listened to and taken seriously. This means that the residents have as much input as possible into the way the home is managed. EVIDENCE: On the day of this visit the registered manager was not available, as she is currently seconded to another Leonard Cheshire Home to cover maternity leave. The acting manager has taken responsibility for managing the home and all other staff have taken on more responsibility. The registered manager still visits the home weekly and keeps in touch at other times by phone. The acting manager said that they work well together and that she has received good support. Hydon Hill Cheshire Home DS0000017618.V346523.R01.S.doc Version 5.2 Page 23 There has been adequate backfill of staff to compensate although both the acting manager and the senior nurse say that it’s been a “real learning curve”. One member of staff said, “We’ve all moved up a notch, it has been good for all of us to take on that bit more responsibility”. Staff and residents spoke very highly of the managers and senior nurse. They said that they are friendly and supportive but firm and that they listen to their ideas and “make them happen”. The acting manager is currently undertaking the RMA/ NVQ IV in management and care. Conversation with her showed that she was very knowledgeable about each resident and their health and social care needs. Residents said that they can talk to “any of the staff” if they have worries or problems. They said that they know they can always talk formally to the manager, but that they “don’t have to”, because, their views are listened to and taken seriously. Staff were very positive in their views of the way the home is managed. They included the registered manager in their comments. They said that the managers do their best to make sure the homes is a well run. They said, “They are fantastic – they listen to us and really support us to do our jobs.” There are good systems for the management of Quality and Health and Safety in the home. In addition to the Annual Quality Assurance Assessment (AQAA), required by the CSCI, the home supplied the CSCI with it’s own quality assurance document and a copy of their newsletter. These documents provided good evidence that there is excellent communication with residents and staff and that their views are sought in a number of ways, including residents’ meetings, staff meetings, informal discussions and more formal consultations. Hydon Hill Cheshire Home DS0000017618.V346523.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 X 29 3 30 3 STAFFING Standard No Score 31 3 32 4 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 4 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 3 3 4 3 X X 3 X Hydon Hill Cheshire Home DS0000017618.V346523.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard YA24 YA27 Good Practice Recommendations The communal areas of the home, particularly the corridors, would benefit from a redecoration programme. A review of the bathroom, shower and toilet areas should be undertaken to ensure they are as homely as possible. Hydon Hill Cheshire Home DS0000017618.V346523.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Oxford Office 4630 Kingsgate Oxford Business Park South Cowley Oxford OX4 2SU National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Hydon Hill Cheshire Home DS0000017618.V346523.R01.S.doc Version 5.2 Page 27 - 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. 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