Random inspection report
Care homes for older people
Name: Address: Holcombe House Butterton Lane Moretonhampstead Newton Abbot Devon TQ13 8PW one star adequate service 03/09/2009 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Anita Sutcliffe Date: 2 0 0 5 2 0 1 0 Information about the care home
Name of care home: Address: Holcombe House Butterton Lane Moretonhampstead Newton Abbot Devon TQ13 8PW 01647440241 01647441146 sueowens@btinternet.com www.holcombe_house.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Sue E. Owens Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Sue E. Owens care home 21 Number of places (if applicable): Under 65 Over 65 0 21 21 dementia old age, not falling within any other category physical disability Conditions of registration: Date of last inspection Brief description of the care home 21 0 0 0 3 0 9 2 0 0 9 Holcombe House is registered to provide accommodation and care for up to twenty-one people who are over sixty-five and who may have dementia and/or a physical disability. Any medical or nursing necessary is met through the community medical services. Care Homes for Older People Page 2 of 10 Brief description of the care home The home is about half a mile from the centre of Moretonhampstead and has panoramic views over Dartmoor. There are 17 bedrooms, four of which are large enough to be occupied by two people. There is a pleasant dining room adjoining the lounge at the back of the house, and another lounge and conservatory at the front. The extensive grounds provide an attractive setting for the home. A written Statement of Purpose and the most recent inspection report are available on request at the home, and a Service Users Guide will be sent to prospective residents on request. The weekly fees are currently between £625 and £391 and additional charges will be made for professional hairdressing, chiropody, newspapers and toiletries. General information about fees and fair terms of contracts can be accessed from the Office of Fair Trading web site at /www.oft.gov.uk . Care Homes for Older People Page 3 of 10 What we found:
The Commission has collected information about Holcombe House since the key inspection 3rd. September 2009. The home provided us with information about the service. This includes data, such as how many staff work there and when policies were last reviewed. It also gives the home the opportunity to tell us what they do well, any barriers to improvement and what improvements are planned. We did one unannounced visit to the home. We looked closely at the care of two people who use the service. We also looked at assessment, care and staff recruitment records. We did a brief tour of the building. We asked questions of staff and the manager, who was present throughout and spoke with a visiting health and social care professional with good knowledge of Holcombe House. We found that peoples needs had been assessed before they were offerred a place at the home. That assessment provided information on each aspect of the persons needs, including that of communication, interests and orientation. There was also detailed information about the persons history, relevant especially where they have to live with the condition of dementia. It was a previous requirement that each person who uses the service must have a current plan of how their care would be delivered. This plan was in place for one of the two people whose care we examined. However, for the second it was not. There was a previous plan from health and social care professionals who had assessed their needs, but the home had not produced one. We spoke with one of the two people whose care we examined but they were unable to tell us what they thought of the service they receive. They had a fractured arm, which was following a fall at the home on 27th April. The document called Falls Risk Assessment records Has fallen rarely but records indicate that she had two falls prior to admission and three at Holcombe House, one resulting in the fracture. Despite this the Falls Risk assessment had not been updated since 2nd February and so the plan of how to care for her had not been reviewed. We found that, although the person fell during the evening of the 27th she did not receive medical attention until the 28th. The care staff had attempted what was inappropriate treatment. We made an Immediate Requirment that the home must be conducted so as to promote and make proper provision for the health and welfare of people, in that medical attention must be sought within a reasonable timescale. The manager responded with an action plan immediately. We saw several people receiving full care in bed. They appeared to be comfortable and well cared for. We spoke with a visiting health and social care professional with good knowledge of the home. Asked what she thought of the care provided at Holcombe House she said she has full confidence in the home, the standard of care is very high and people
Care Homes for Older People Page 4 of 10 who use the service and their family are very happy. She has no concerns. We found that the home is not notifying the Commission of incidents that affect the wellbeing of people at the home. We had not been informed of the fall, fracture and hospital visit which occurred. Mrs. Owens told us that currently no people are prescribed medicines known as Controlled Drugs. We looked at the medicines records. They appeared to be orderly, clear and complete. Medicines appeared to be correctly stored and we have no reason to beleive medicines are not correctly handled at the home. The previous good practice recommendation to complete the policy on Homely medicines is now met. We did a brief tour of the building. It was clean, fresh and appeared well maintained. The previous requirement to remove the risk of contact burns from uncovered radiators has now been met. We saw that there is liquid hand soap and paper towels available for staff to wash their hands where ever personal care is provided. We did not ask staff what they would do should they have concerns which might be abuse but Mrs. Owens told us they have received training in how to safeguard vulnerable adults from abuse and she has checked to ensure they understand. We were shown documentation relating to this. We looked at the recruitment records of the last two staff employed at the home and spoke to one of them. Mrs. Owens told us that the history of both staff was known to her prior to their employment. We found that the required checks, to ensure the staff are safe to work with vulnerable adults, had not been completed. Despite prior knowledge of the person it is prudent to complete the checks and ensure robust recruitment. We had received an anonymous complaint against the home. Part of that complaint included the employment of people without fully checking their background. This was found to be the case. We were unable to substantiate the second part of the complaint but Mrs. Owens is aware of the allegation. We found that peoples confidential personal information is being left in the entrance hall of the home where those who do not have a right to see it will be able to do so. We also find that such information is easily accessible in the recess near to the lounge/dining area. The home must operate in compliance with the Data Protection Act 1998 in that personal information about people must be kept confidential. What the care home does well: What they could do better:
Each person must have a current plan of how their care is to be delivered, which is reviewed as their needs change. Care Homes for Older People Page 5 of 10 Medical attention must be sought within a reasonable timescale following an accident. Staff must not be employed to work in the home until all relevant checks have been completed so that all staff are safe to work with the vulnerable adults in the home. Records must be complete and confidential information must be stored so that only those with a right to see it can do so. The home must notify the Commission of any incident or accident that affects the wellbeing of people who use the service. This includes falls where people need medical attention. 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 2. Care Homes for Older People Page 6 of 10 Are there any outstanding requirements from the last inspection? Yes R No £ 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, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action 1 7 15 After consultation with the 31/10/2009 person, the home must make a written plan of how their needs are to be met. The plan must be reviewed and updated as preferences and needs change. So that staff are aware of what care and support the person needs. 2 37 17 Records required by 30/11/2009 regulation for the protection of people and the effective running of the home must be up to date and accurate. For the protection of people who use the service and the efficient running of the business. Care Homes for Older People Page 7 of 10 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 1 10 12 Medical attention must be sought within a reasonable timescale. To promote health and wellbeing. 25/05/2010 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 6 15 After consultation with the 31/05/2010 person, the home must make a written plan of how their needs are to be met. The plan must be reviewed and updated as preferences and needs change. So that staff are aware of what care and support the person needs. 2 33 37 The home must notify the 31/05/2010 Commission, within a reasonable timescale, of any event which affects the wellbeing of people who use the service, including a fall which results in medical attention. For the protection of people who use the service. 3 37 17 Records required by regulation for the protection of people and the effective 31/05/2010 Care Homes for Older People Page 8 of 10 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 running of the home must be up to date and accurate. For the protection of people who use the service and the effective running of the business. 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 9 of 10 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 10 of 10 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
