Care Home: North Hill

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What the care home does well All of the comments received from talking to people were positive and included "I am happy here" "The staff are good, they give me the help I need" "I am satisfied" "I can talk to any of them" "I have no grumbles. it`s more than alright" Each person had a care plan that set out their needs to make sure these were met. Health care was monitored and access to health professionals was provided to maintain health. Staff appeared respectful of people living at the home so that their dignity was kept. Open visiting was provided so that people could maintain relationships. A range of activities was provided so that people had choice about how to spend their time. A varied menu was available to provide choice and promote health. Adult safeguarding and complaints procedures were in place to promote safety. The environment was well maintained and decorated so that people had a comfortable place to live. Sufficient staff were provided to meet peoples needs. A programme of training was in place to ensure staff had the necessary skills to carry out their duties. Thorough recruitment systems were adhered to to keep people safe. All of the people spoken with said the manager was approachable and supportive. A quality assurance system was in operation to obtain and act upon peoples views. Health and safety systems were checked and serviced so that peoples safety was promoted. What has improved since the last inspection? Recruitment files contained full employment histories to evidence that thorough checks had been made. The environment had been maintained and redecorated on an ongoing basis to keep good standards. What the care home could do better: Care plans should contain further information on the specific staff actions required to meet personal care needs so that individual preferences are respected. Medication administration records must only be completed after a medication has been taken to keep people safe. The ground floor corridor carpet must be replaced as planned within the homes maintenance programme. Records must be securely stored at all times to maintain confidentiality. Inspecting for better lives Key inspection report Care homes for older people Name: Address: North Hill 2 North Hill Road Southey Green Sheffield South Yorkshire S5 8DS     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: Janis Robinson     Date: 2 3 0 3 2 0 0 9 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. 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. 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 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 Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: North Hill 2 North Hill Road Southey Green Sheffield South Yorkshire S5 8DS 01142855773 01142316708 northhill_902@fsmail.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: North Hill Care Homes Ltd care home 28 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home North Hill is a care home providing personal care and accommodation for 28 older people. The home is situated in the residential area of Southey Green in north Sheffield, close to Hillsborough. A small shopping area and public transport stops are close to the home. Car parking is provided at the home and roadside parking is also available. North Hill was registered in the early 1990s and is built on three floors, the rooms on the second floor having dormer-style windows. A lift is available to all floors. All accommodation is provided in single en-suite bedrooms. A conservatory is provided and a lawned area is located to the rear with small garden areas to the front and side aspects. Written information about the home, including the most recent inspection report, are available from the home. Care Homes for Older People Page 4 of 26 Over 65 28 0 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: two star good 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 2 star. This means that people who use the service experience good quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. In future, if a requirement is repeated, it is likely that enforcement action will be taken. This was an unannounced inspection carried out by Janis Robinson, regulation inspector. Prior to the visit the manager had submitted an Annual Quality Assurance Assessment (AQAA), which detailed what the home was doing well, what had improved since the last inspection of 22/03/07, and any plans for improving the home in the next twelve Care Homes for Older People Page 6 of 26 months. Information from the AQAA is included in the main body of this report. The home was visited on the 23rd of March 2009. The manager and administrator were spoken with about the running of the home. Some senior and care staff were spoken with about working at the home. Two care staff were formally interviewed about their skills and experience. Eight people living at the home were spoken with about the support they received. Interactions between staff and people living at the home were observed. A selection of records were examined, including three peoples care plans and records related to the running of the home. An inspection of communal and some individual rooms took place. At the time of this inspection fees ranged from 327 to 360 pounds each week. What the care home does well: What has improved since the last inspection? What they could do better: Care plans should contain further information on the specific staff actions required to meet personal care needs so that individual preferences are respected. Medication administration records must only be completed after a medication has been taken to keep people safe. Care Homes for Older People Page 8 of 26 The ground floor corridor carpet must be replaced as planned within the homes maintenance programme. Records must be securely stored at all times to maintain confidentiality. 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.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 9 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 10 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were able to visit the home, and written information was provided to people so that they could make an informed choice. Peoples needs were assessed prior to moving in to the home to make sure these could be met. Evidence: A statement of purpose and service user guide were available at the home, which were seen. These included a range of information. People spoken with said that they had been provided with copies of the service user guide. Three care plans were checked in detail. Each contained a copy of the homes own assessment document, alongside a copy of the social workers assessment. The manager stated that she carried out all assessments by visiting people in their own homes, or in hospital. The manager confirmed that no person would be admitted to Care Homes for Older People Page 11 of 26 Evidence: the home without an assessment taking place. The three assessments seen were comprehensive and set out all aspects of a persons care needs and preferences. The information included on the assessment forms was detailed in the care plans seen. People spoken with said that they had been able to visit the home before choosing to move in, to look around, view the accommodation and meet other people living at the home and staff. Care Homes for Older People Page 12 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. Peoples personal and health care needs were identified so that they could be met. Medication systems, on the whole, protected people, but safe systems were not routinely adhered to which could place people at risk. Evidence: Three care plans were checked in detail. They were well set out and contained a comprehensive range of information that covered all aspects of health and personal care. The plans included some information on the staff actions required to make sure identified needs were met, but these were generic statements such as One person assist to wash, rather than specific guidelines about the staff actions required. Peoples preferences had been sought and were reflected throughout the plans. All three care plans were up to date and had been reviewed on a monthly basis. Risk assessments had been undertaken, which covered all aspects of daily living. Those seen had been reviewed and were up to date. The care staff spoken with appeared knowledgeable about individuals needs and preferences. Care Homes for Older People Page 13 of 26 Evidence: All of the care plans seen contained full information on the persons health care. Details of any medical conditions were included in the plans and they all contained information on ongoing treatment, appointments and contacts. People spoken with said that their health care needs were met. One person said that they saw their GP when needed, and also saw a chiropodist, dentist and optician. A medication policy was in place and seen. Senior staff administered medication and the training records seen evidenced that they had been provided with training in safe medication. Medication was stored securely. Medication administration records (MAR) were checked and found to be fully completed. Part of a medication round was observed, staff were seen to record in the MAR that medication had been administered before the person was given their medication, however, all other records were undertaken after medication had been administered. All of the people spoken with said that staff were respectful and their right to privacy was upheld. The interactions observed between people living at the home and staff appeared positive and inclusive. Staff took time to chat to people and were seen to knock on doors and wait for a response before entering. People made very positive comments about staff, which included, They are very good They give me the help I need They are all alright, I can talk to any of them They look after you Care Homes for Older People Page 14 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Open visiting, a range of activities and a varied menu were provided so that people had choice. Evidence: An activities worker was employed and an activities programme was on display which showed that a variety of activities was provided. These included gardening, quizzes, exercises, and crafts. Religious services were also provided should people wish to attend. People were seen participating in an exercise class, and much laughter and positive interaction was overheard. Comments from people about the activities provided were very positive, and included The activities make a hugh difference, they help fill my day and keep my spirit up I join in the activities. Its great now. Before we did very little People said that the routines at the home were flexible, they could get up and go to bed when they wanted. Visitors could come to the home at any time and people could spend time in their rooms with visitors if they wanted privacy. The care plans seen and interactions observed showed that people were provided with choice and their Care Homes for Older People Page 15 of 26 Evidence: preferences were respected. Throughout the day staff were observed talking to people and offering them choices, for example, where they wanted to sit and what they wanted to eat and drink. Individual rooms seen showed that people had brought some personal possessions with them into the home. The menu was seen, which was varied. Choices were offered at the main meals of the day and the cook said that alternatives to the two choices offered were always available. Special diets were catered for. Plentiful food stocks were seen in the kitchen and the mid day meal was well presented and appeared appetising. All of the people spoken with said that they liked the food and were happy with the choices offered. Care Homes for Older People Page 16 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaints and safeguarding procedures in place protected people. Evidence: A written complaints procedure was in place, which was seen. People were provided with information about how to make a complaint within the service user guide. The complaints procedure was also on display in the entrance area. The record of complaints was checked, these recorded the action taken and the outcome of the complaint. People spoken with said that they had no need to make a complaint, but if they did would go to staff or the manager, who would listen to them. An adult protection policy was in place. Staff spoken with understood the different types of abuse and were clear of the action to take if an allegation was made or if they suspected abuse. A programme of adult protection training was in place, and the records checked showed that all of the staff had undertaken this training. All of the people spoken with said that they felt very safe at the home. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were provided with a good standard of accommodation so that they had a pleasant place to live. Evidence: An inspection of the majority of the environment was undertaken. The gardens were well maintained and provided with seating so that people could sit outside if they chose. The home appeared well maintained. Communal areas were well decorated and provided with pictures and ornaments to create a homely environment. Most furniture was in good condition. This created a warm and welcoming impression of the home. However, the ground floor corridor carpet was damaged in places. It is acknowledged that the carpet is due to be replaced within the homes maintenance plan. The individual accommodation seen appeared well maintained. However, a minority of bedroom furniture was showing signs of wear. Bedrooms had personal possessions so that people had control over their individual accommodation. The home was clean and fresh smelling. Bathrooms were provided on each floor, those seen contained moving and handling equipment to help meet peoples needs. Staff were observed wearing aprons and gloves when necessary. All of the people spoken with said that they were happy with the accommodation provided, and had everything they needed. One person said Its lovely here, its very clean and I like that Care Homes for Older People Page 18 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. The staff recruitment and training provided promoted peoples safety. Evidence: The staffing rota was examined, which showed that staffing levels were being maintained. All of the people spoken with felt that enough staff were provided. Comments about staffing were positive, and included, The staff are good They come as quick as they can when you buzz The staff are kind National Vocational Qualifications (NVQ) were available to staff. Of the 23 care staff, 15 had achieved NVQ level 2 in care . Three staff recruitment files were checked. They contained all of the required information and included a photograph, proof of identity and qualifications, an application form, written references and an employment history. The files contained evidence that a Criminal Records Bureau (CRB) check had been undertaken at enhanced level. Care Homes for Older People Page 19 of 26 Evidence: A programme of staff training was in place. Staff spoken with confirmed that they had been provided with induction training. The training records checked showed that a range of relevant training was provided to staff, for example, dementia awareness, depression, oral hygiene and foot care. Care Homes for Older People Page 20 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefited from the managers leadership. Peoples views were sought so that these could be acted upon. Peoples money was well managed so that they were safeguarded. Staff were provided with regular supervision to appraise their skills. Health and safety systems were maintained to keep people safe. Insecure storage of some records did not uphold peoples right to confidentiality. Evidence: People living at the home and staff said that the manager was friendly and they could go to her at any time. Comments included She is a good listener Care Homes for Older People Page 21 of 26 Evidence: Her door is always open Very approachable Staff said that the manager was approachable and she listened to them. The manager and administrator were well organised and all of the documents seen were up to date. A quality assurance system was in place. Surveys with people living at the home and their relatives were undertaken. The results of these were audited and published, alongside an action plan that was undertaken in response to the results of the survey. Spending monies were kept for some people. Records of these were sampled. Each transaction was recorded and receipts kept. Money was stored securely. Records seen and talking to staff showed that care staff had been provided with supervision at the recommended frequency. Staff meetings regularly took place. Whilst care plans were securely kept, a storage cupboard that contained archived care plans and staff files was found unlocked. Health and safety systems were in operation and records seen verified that systems were checked and serviced. Weekly fire alarm checks had been undertaken. Regular fire drills took place, and all of the staff spoken with confirmed that they had participated in a practice drill within recent months. Records of staff training showed that all mandatory training was provided on a rolling programme. All staff were up to date with mandatory health and safety training. Care Homes for Older People Page 22 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 23 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 1 9 13 Medication administration records must be completed after a person has taken their medication so that safe procedures are adhered to 29/05/2009 2 19 16 The damaged corridor carpet 30/06/2009 must be replaced to maintain good standards 3 37 17 All records relating to staff and people living at the home must be securely stored to respect privacy 29/05/2009 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 1 7 Care plans should include further specific detail on the actions required of staff to meet personal care needs so that peoples preferences and individual abilities are Care Homes for Older People Page 24 of 26 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 respected. 2 24 Bedroom furniture that is beginning to show signs of wear should be identified for replacement within the homes maintenance plan to maintain good standards of accommodation. Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or 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) 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 Older People Page 26 of 26 - 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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