Inspection on 01/07/09 for Hollybank

This is the latest available inspection report for this service, carried out on 1st July 2009.

CQC found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Hollybank 07/11/06

Hollybank 24/01/06

Hollybank 29/07/05

Hollybank 03/03/05

Hollybank 02/08/04

Similar services:

Thornton Lodge

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Extracts from inspection reports are licensed from CQC, this page was updated on 15/11/2009.

Key inspection report Care homes for older people Name: Address: Hollybank 27 Park Road Southport Merseyside PR9 9JL     The quality rating for this care home is:   two star good 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: Anthony Cliffe     Date: 0 1 0 7 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 28 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 28 Information about the care home Name of care home: Address: Hollybank 27 Park Road Southport Merseyside PR9 9JL 01704530748 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Ann Mallinson care home 16 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category terminally ill Additional conditions: Service users to include up to 16 OP and up to 2 TI Date of last inspection Brief description of the care home Hollybank is a privately owned Care Home providing nursing care for sixteen older people. Accommodation at Hollybank comprises of ten single bedrooms with one ensuite and three double bedrooms with one en suite. Hollybank is situated in a quiet residential area of Southport close to the town centre, local amenities, the beach and Hesketh Park. The home consists of a four-storey building with a large garden at the front and small patio to the rear. The home has a passenger lift and there is wheelchair access to the front door. People living at the home have the use of a call bell with an alarm facility and there is equipment in place to assist those who are less independent. The fees for accomodation and services cost five hundred and ten pounds per week. The only additional fees charged are for hairdressing, chiropody and newspapers. Information about the home can be obtained by contacting the manager Care Homes for Older People Page 4 of 28 Over 65 16 0 0 2 Brief description of the care home as well as a copy of our last visit report. Care Homes for Older People Page 5 of 28 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: References to we, our or us represent the Care Quality Commission. This unannounced visit took place on 1 July 2009 and lasted over six hours. One inspector carried out the visit. This visit was just one part of the inspection. Other information received was also looked at. Some weeks before the visit the manager was asked to complete a questionnaire called an Annual Quality Assurance Assessment (AQAA) telling us what they thought they did well, what they needed to do better and what they had improved upon since our last visit, to provide us with up to date information about the services provided. This helps us to decide if the managers of the home see the service they provide in the same way we do and if our judgements are consistent with home owners or managers. Care Homes for Older People Page 6 of 28 During our we looked at various records and the premises. We spoke with people living at the home, a relative, staff and the manager and they gave their views about the service. We provided questionnaires for people using the service, staff and health and social care professionals involved in their care so they could tell us their views about the service the home provides. In January 2008, following complaint we had received about the home, we did a a short unannounced visit there to check on the standards of meals provided. During that visit we did not find any concerns about the meals being offered and served and received lots of compliments about the food provided in the home. At that inspection we made some recommendations, which are suggestions we make on how services can be improved. We found at this visit the recommendations we had made in January 2008 had been acted upon and this showed us that the owner and managers are keen to make sure the service continues to improve. In June 2008 we did an annual service review of the home, which told us the home was still providing a good service. An annual service review is a summary of our knowledge about how a service that has not had a visit during the previous twelve months is still performing. It is also how we decide if a service is still as good as we thought it was since out last visit or annual service review. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: Action should be taken to improve how decisions about daily living made by people living at Hollybank are reflected in their care plans. This is to make sure that staff and others involved in their care understand how important peoples decisions about their lives are to them and so agreements about how people make or are supported to make decisions are clearly understood. People living at Hollybank should be provided with more opportunities to be involved in recreational and social activities of their choice so they can live fulfilling lives. Care Homes for Older People Page 8 of 28 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 9 of 28 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 28 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. Information is provided to people that use services about Hollybank so they can decide if the home is suitable to meet their needs. Information is gathered about the needs of people that use services so they can decide if the home can provide the right care to meet their needs. Evidence: We saw that the home provides information to people that use services in a welcome pack. The welcome pack contained useful information about the facilities and services available at the home as well as how care could be arranged so people choosing a home could decide if it could meet their needs. This information was also included in more detailed information called the service user guide. The report from out last visit was also available to people living at the home so they could see what we thought about the home. The home does not charge any additional fees on top of those already agreed so provides value for money. Before the visit we received surveys from people that lived at the home that said they received information about Hollybank Care Homes for Older People Page 11 of 28 Evidence: which helped them decide they wanted to live there. People choosing a care home are encouraged to visit the home and can have a trial period so they can decide if they want to live there and the home meets their expectations. Gathering information about the needs of people choosing the home was done by the manager or someone else from the home so they could explain things, answer questions and provide information about the home. Information was gathered about the medicine people took, physical health, allergies, eyesight, continence, hearing and mental health. Gathering information about people choosing a home included getting information from families and health and social care professionals with an interest in their care so a variety of important information was sought on which to plan the care that people needed. The home also plan to include the cook and care staff in future visits to people choosing a care home so they can get more information about their food preferences and routines and decisions about how they want their care to be provided so their care is based on their choices. Care Homes for Older People Page 12 of 28 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 are supported to be safe and well but information held about them does not support that they are directly included in the decision making process so are not always involved in everyday decisions or decisions about their care. Evidence: We saw that information was gathered about the needs of people that use services so staff had information to provide support and care. We could see that the home uses a person centred approach to providing care and support for people living at the home so their care was based around their needs and choices. The home used some areas of what is called person centred planning. Person centred planning is finding ways of listening to people to find out what is most important to them and what they want from their lives. The next step is to help people get those things. Person centred thinking helps staff who care and support people to listen to them and then to help them get what they want. A person centred plan contains information on what is positive about people, for example what people like and admire about them and their gifts and talents. Information should be included about what and who is important to people from their viewpoint, as well as what people want for their future. A person Care Homes for Older People Page 13 of 28 Evidence: centred plan should have information about how people want to be supported so they can stay healthy, safe and well. This is called a support plan but may be called a care plan. This should be detailed enough to provide a living description of how people that use services want to be supported, how they make decisions and show who will do what by when. The information the manager sent to us before the visit said the home offers person centred care and supports people that use services to make choices about their health and personal care by choosing their own clothes and hairstyle and decisions about their care. The care plans we saw were individual to people living at the home and included some information about their routines and choices about personal care. The care plans we saw said some positive things about how people could help themselves. They did not show how people wanted their care to be arranged, how staff would provide support or care to help them to care for themselves or if care was arranged or planned around their daily routines. So care based on their personal preferences was not always provided; for example, routines around personal care and bathing. Care plans did provide staff with some guidance on supporting people to remain independent by encouraging them to attend to their personal care and saying how people helped themselves. The home had been gathering information about the life histories of people living there. This information was included in the care plans the home had written to support and provide care for them so staff had information to provide care. We could not see examples of how people living at the home chose their daily routines and followed their own lifestyles. People had signed their own care plans but we could not see how they had been involved in writing their care plan. This meant they might not know what was written in them or understand some of the medical words used. We saw that staff treated people living at the home with courtesy, dignity and respect and sought their views about how they wanted to be supported. We saw staff help people to make decisions. We saw care plans refer to staff encouraging people living at the home to make decisions for themselves but the information needed to be clearer if they lacked capacity, experience or judgement to make them. We could not could not see written why, when, where and how staff supported people to make decisions so were unsure what decisions they made for them or supported them to make. We saw that care plans about how people living at Hollybank communicated were used and told staff about the difficulties that people had in making themselves understood. We saw care plans that told staff about the individual ways or different Care Homes for Older People Page 14 of 28 Evidence: methods that people living at the home used to communicate so they could understand them and support them to tell staff what they wanted. Care plans contained important information about the health of people living at the home. An example of this was a person who had a number of pressure ulcers when they moved into the home. With advice from health professionals the persons skin was healing. Information called a nutritional assessment said if people using the service had problems with eating, so risk assessments and care plans had been written to make sure that peoples eating and weight could be watched. The home had also purchased a hoist with scales on it so people could be weighed accurately. The home had medical cover from local GP surgery so people living there had their health needs looked at regularly. Staff at the home gathered information about how much people living there eat and drink, how much they weigh, if their skin is in danger of breaking down, their ability to mobilise and walk or if they are in danger of falling as well as their ability to care for themselves. This meant that staff had information on which to provide care and support. The skin care specialist gives advice to staff at the home when needed and we could see the home only had one person with a pressure ulcer. The home is able to provide palliative and end of life care. Staff have had end of life care training so they are able to provide care for people who are dying. Before our visit a local doctor returned a survey to us that said the home always sought and acted on advice to improve the health needs of people living at Hollybank. People living there also returned surveys to us and said they were always supported to have their health care needs looked after. Medication policies and procedures were detailed so staff understood their responsibilities and accountability for their actions when administering medicines to people that use services. The home had storage facilities for medicines as well as policies and procedures for medicine administration. We looked at the arrangements for the ordering, receipt, administration and disposal of medicines and controlled drugs and found no errors so people that use services were receiving their medicines safely. The manager showed us the arrangements for giving out medicines and we could see that people had their medicines at the times they wanted to take them so medicines were administered individually. Care Homes for Older People Page 15 of 28 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. People living at Hollybank are supported to make choices but could be offered more opportunities for recreational and social contact so they have control over and lead more fulfilling lives. Evidence: Before the visit we received surveys from people who live at Hollybank that said the home always or usually arranged activities they could join in. Comments received were, They provide activities and I join in if I want to. At the time of our visit an activities co-ordinator was employed at the home so there was someone to plan and encourage people to do activities. We saw staff providing some activities during the day so people living in the home had some opportunities for social and recreational contact. We saw some people reading newspapers and magazines, watching TV and listening to music. We saw some people sleeping at times or being cared for in bed so were not engaged in doing anything. The manager said due to the age and physical condition of people they did not always want to be involved in activities. Activities were mainly arranged around the choices of people living at the home so they decided when they wanted to be involved in them. The activities coordinator did massage on one person and had training to do this. The Care Homes for Older People Page 16 of 28 Evidence: person who had the massage said she found this very relaxing. Activities provided were based on information taken from the life histories gathered about the people living at Hollybank. The activities were arranged around their choices, such as gardening, baking, massage and cooking. The home also has a lap top computer that people living there can use to access the Internet. Memory boxes about your wedding day and washing day have been made as well as the introduction of a newsletter so people living at Hollybank are aware of what is happening in and outside of the home, as well as having interesting things to talk about. Meals were seen to be varied to support a balanced diet, with advice sought from dietitians where necessary. The menu provided a varied diet and meal times were quiet. People chose where they wanted to eat so staff could support them to enjoy their meals without interruption. The menu for the day was displayed on a white dry wipe board in the dining room. The home provides a three week menu and there are some set meals that people enjoy; for example, on Saturdays people like a cottage pie or casserole. The menu of the day was displayed in the main lounge. The manager noticed that if people chose not to eat in the dining room they did not always see what the choices of meals available, as the information was not displayed elsewhere. The manager said she would ensure all people who chose not to eat in the dining room were aware of the meals on offer. Due to the weather being hot on the day of our visit, the menu was changed and people were offered a choice of chicken or broccoli quiche with salad and chips. Information about peoples meal preferences was gathered before they moved in so their preferences were known and could be included in the menu. Three meals a day were offered as well as drinks and snacks throughout the day. The chef kept a record of all meals served at the home so we could see a varied menu was offered. We shared a meal with people using the service. They told us they enjoyed their meals and what was provided was what they have had if they lived at home. Care Homes for Older People Page 17 of 28 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. People living at Hollybank are protected by the safeguarding adults procedure in place at the home so they can be confident they will be safe at all times. Evidence: The information the manager sent to us before the visit said the home had not received any complaints. We looked at the records of complaints and verified this. The complaints procedure is available for people to see at the main entrance. Before the visit we received surveys from people that live at the home telling us they knew who to speak to if they had any concerns and knew about the complaints procedure. We spoke with people living at the home as well as a visitor. The visitor said, They listen and act on what you ask or say and any concerns are dealt with immediately and I cannot complain about anything. This is why I think this is a very good home. A person living at Hollybank told us, I have everything I need, great care, great food and medical attention when I need it. I have no complaints about being here or to make. Policies and procedures were in place to protect vulnerable adults called the safeguarding adults procedures. The safeguarding adults procedure is how we, the local council, police and other agencies respond to and manage allegations or suspicions of abuse against vulnerable adults. Records we saw showed that eight staff did safeguarding training with Sefton Council Care Homes for Older People Page 18 of 28 Evidence: in March 2009 and the rest of the staff team were to do the training in July 2009. This provides them with information on how to recognise and respond to suspicions of abuse and means they will know what to do to protect the people who live at the home. There was a copy of Sefton councils safeguarding adults procedure at the home so that staff had guidance on what they should do. The manager said the home had never had to make a safeguarding referral and explained if needed the registered nurse on duty would be responsible for making sure the necessary procedures were followed to protect the people living at the home. Staff were also issued with the General Social Care Council code of practice. This is a guide for social care staff on the standards expected of them so they were aware of their responsibilities when providing care for people that use social care services. Staff also had access to the whistle blowing policy, which is a policy they could follow if they needed to tell other organisations about things in the care home that concerned them. Care Homes for Older People Page 19 of 28 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. Hollybank is maintained so that it provides comfortable and safe surroundings for the people who live there and their health and safety is promoted. Evidence: We looked around the building and found it to be comfortable and homelike. The owner had continued with decorating bedrooms and replacing the carpets in some. Two bedrooms had windows replaced. Bedrooms contained items of furniture and electrical equipment belonging to people that live at the home so they could personalise their bedrooms to their tastes. People living at Hollybank said the home was comfortable and a nice place to live. The owner had purchased new flat screen televisions for some of the people living there and had satellite television installed in some bedrooms. The owner had, as recommended at our last visit, put disposable paper hand towels in toilets so the risk of cross infection is reduced. We found two toilets that did not have locks on them so people could not maintain their privacy when using these facilities. The manager agreed to fit privacy locks to the doors. Care Homes for Older People Page 20 of 28 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. Good employment procedures and a varied training programme are in place so people that use services are protected by a thorough recruitment process and a skilled staff team. Evidence: We saw the staff numbers in place supported the needs of people living at Hollybank so they had sufficient help with their needs. The home was not fully occupied at the time of our visit and there were sufficient staff to provide care and support for the number of people living at the home. The manager works at the home five days a week and is included in the staff on duty so is able to offer support and supervision to the staff team. The staff induction programme used at the home was based on Skills for Care induction standards. These are nationally recognised standards for people who work in social care so staff understand their roles and responsibilities. Of the eleven care staff employed at the home, five have a national vocational qualification (NVQ) in care at level 2. This means they have been assessed as competent to provide care for the people living in the home. Two staff had also completed an NVQ level 3 and another staff member was working toward completing one. NVQ qualifications are nationally recognised qualifications in social care. Care Homes for Older People Page 21 of 28 Evidence: We looked at the recruitment records of two staff employed at the home. Recruitment procedures were good and included staff having to complete an application form, full employment history and then two references were sought about their suitability for employment. The recruitment of staff also included a Criminal Records Bureau (CRB) disclosure which is a check of staff to see they are suitable people to provide personal care and support to vulnerable adults. Staff were provided with training which included infection control, safer food handling, safeguarding adults, moving and handling, fire safety, continence promotion, safe administration of medicines, infection control and caring for people with Parkinsons disease or stroke, so a varied training programme is provided for staff. The manager provided us with a record of all staff training that had been planned and completed, as well as having individual training files so we could see staff were provided with regular training to be able to do their jobs. Before our visit staff returned surveys to us that said they received regular support from the manager and training that helped them to do their jobs. Staff commented that they felt there was a calm and supportive atmosphere at the home and people received a good standard of care with old fashioned values. Care Homes for Older People Page 22 of 28 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. Quality assurance checks carried out at the home identify areas for further development so the welfare of people living at Hollybank is promoted and the home is run in their best interests. Evidence: The manager holds an NVQ level 4 qualification in management and has managed the home for 26 years. The home has an open visiting policy with the manager available to talk to people living at the home or visitors so is able to listen to concerns. The manager was described as seeing people as people and treating them as though they are family. The manager completed checks on a number of things in the home to make sure the home was managed properly. This included making sure that important information was gathered about the home, checking how safety was maintained, that staff were doing their jobs correctly and that people that lived there were satisfied with the care Care Homes for Older People Page 23 of 28 Evidence: they received. This is called quality assurance and was being carried out by doing lots of checks called audits so the manager could see how everything was working in the home. In May 2009 the manager did an audit of the activities the home provides using surveys so she could see if people were satisfied with how activities were arranged. People were asked about the length and type of activities offered or if they preferred one to one activities as well as asking what activities they would like to see take place. Five people that lived at the home returned surveys and said they wanted one to one activities and individual interests such as backgammon, Monopoly and card games. The manager had also done an audit of the meals served in April 2009 and asked people what they thought of the meals offered so they could comment about the standards of food served. People were asked about the quality, variety, quantity and presentation of meals. Most people living at the home said meals were good or excellent. They said they received healthy meals with wholemeal bread, baked potatoes, rice, cous cous and pasta served on the menu. The home had also taken part in a local NHS scheme to improve the standard of hand washing in care homes so cross infection is reduced. The manager had also started to look at the standard of record keeping in the home so she could see how people living in the home could be more involved in how they wanted their care arrangements, with decisions about this recorded so they decided when and how they wanted their care to be provided. The owner also uses an independent person to do satisfaction surveys for people using the service and relatives each year so they can comment or make contributions to how the home is managed and what they think of the facilities and services offered. Twelve surveys were sent to people living at the home asking them twenty five questions and for them to make comments about the accommodation, staff, quality of meals, visiting arrangements, privacy and dignity, activities and how people were supported to be independent and their opinions respected. People living at the home said they were 97 satisfied with living at Hollybank. Surveys were also sent to relatives or other with an interest in the care of people living at Hollybank asking them twenty four questions and for them comment about the accommodation, staff, quality of meals, visiting arrangements, privacy and dignity, activities, how people living at Hollybank were supported to be independent and if their opinions were respected. Eight surveys were returned and these showed that relatives and others were 96 satisfied with the standards at Hollybank. Staff at the home do not act as appointees for any people living there or manage finances on their behalf. Some money was held at the home on behalf of people, to be Care Homes for Older People Page 24 of 28 Evidence: used to pay for chiropody, newspapers, hairdressing and personal items so people using the service could buy things they wanted. Balances were checked against the records and the amounts held tallied with the records kept , showing us that financial procedures were safe. The AQAA told us that all the required maintenance checks and health and safety checks had been completed as required so people living at Hollybank lived in a safe building. We checked the records for fire safety and found all fire safety systems were checked regularly to make sure they were working effectively. Care Homes for Older People Page 25 of 28 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 26 of 28 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 1 7 The home should should improve how decisions about daily living made by people living at Hollybank are reflected in their care plans. This is to make sure that staff and others involved in peoples care understand how important peoples daily decisions about their lives are to them and so that the agreements about how they make or are supported to make decisions are clearly understood. People that use services should be provided with more opportunities to be involved in recreational and social activities of their choice so they can live fulfilling lives. 2 12 Care Homes for Older People Page 27 of 28 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). 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. 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