Inspection on 01/10/08 for Holcroft House

This inspection was carried out on 1st October 2008.

CSCI found this care home to be providing an Adequate 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

Holcroft House 04/10/06

Holcroft House 23/11/05

Holcroft House 30/09/04

Holcroft House 06/07/04

Extracts from inspection reports are licensed from CQC, this page was updated on 05/12/2008.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Holcroft House Holcroft Road Thornhill Southampton Hampshire SO19 6GH     The quality rating for this care home is:   one star adequate 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: Mick Gough     Date: 0 1 1 0 2 0 0 8 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. the things that people have said are important to them: They reflect 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 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Holcroft House Holcroft Road Thornhill Southampton Hampshire SO19 6GH 02380402689 Telephone number: Fax number: Email address: Provider web address: annjewell@southampton.gov.uk Name of registered provider(s): Name of registered manager (if applicable) Mrs Ann Jewell Type of registration: Number of places registered: Southampton City Council care home 35 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: Date of last inspection Brief description of the care home Holcroft House is a residential home providing care and accommodation for up to 36 older people, with capacity for six people in the dementia care category. The home offers a respite care service when accommodation is available. Mrs Ann Jewell manages the home on behalf of the proprietors Southampton City Council. The home is a single storey property located in the residential suburb of Thornhill, about three miles east of Southampton city, with its shops and amenities. 0 Over 65 35 Care Homes for Older People Page 4 of 27 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: one star adequate 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: This report details the evaluation of the quality of the service provided at Holcroft House and takes into account the accumulated evidence of the activity at the home since the last visit to the home, which was carried out in October 2007 and the last annual service review of the home which was also completed in October 2007 The inspection took into account the homes Annual Quality Assurance Assessment (AQAA) which was sent to us prior to the visit to the home; and comment cards received from 9 members of staff and 3 users of the service. An unannounced site visit to the home took place on the 1 October 2008. During the site visit we had the opportunity to tour the home, read and inspect records and also Care Homes for Older People Page 5 of 27 observe the interaction between staff and users of the service. We spoke to 10 users of the service, 1 relative 5 members of staff including 2 care co-ordinators and the manager of another Southampton City Council home who assisted us during the visit. The home is registered to provide support for 36 service users but at the time of the inspection there were 31 service users living at the home. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get Care Homes for Older People Page 7 of 27 printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 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. No service users move into the home without having their needs assessed. The home does not provide intermediate care. Evidence: The home carries out an individual needs assessment prior to service users moving into the home and there is a clear admission process and assessments were on file at the home and were looked at for the 3 residents case tracked. Assessments were made using a needs assessment form and residents were visited before they moved into the home. Care management assessments were also on file. Intermediate care is not provided at the home. Care Homes for Older People Page 10 of 27 Care Homes for Older People Page 11 of 27 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. Residents health, personal and social care needs are set out in a individual plan of care however some amendments are needed to ensure that staff have all the information they need to provide the support residents require. Medication procedures are generally sound however improvements should be made to ensure that all medication administration records are correct and provide a clear audit trail. The health care needs of service users are met and service users at the home are treated with dignity and respect. Evidence: Care plans were inspected for 3 residents and these were clear and generally provided good information for staff. Care plans seen contained information on relationships, relatives, communication, religious needs, health care needs, falls, daily living, night support, memory and eating and drinking. The plans gave information for staff on the support required, however the care plan for one resident stated that the person was Care Homes for Older People Page 12 of 27 Evidence: usually happy but was prone to tearfulness and that they were quite emotional, this part of the care plan did not provided any information for staff on how they should support this person if they were tearful. The care plan for another resident stated that this person was getting very disoriented about time and was changing clothes 3 or 4 times a day, again there was no information for staff on how they should support this person. Care plans were easy to follow and were regularly reviewed, however review notes did not provide any information on how the care plans were working. The review notes seen had very little information and they would benefit from more information and evaluation on how the care plan has been working so they could provide information on any progress of lack of it as the case may be. There were risk assessments in place but these were mainly tick boxes and did not always provide sufficient information for staff on how identified risks could be minimised. The forms used did not provide sufficient space for clear guidelines for staff to be written. One risk assessment stated that a resident needed the support of one staff member to mobilise but there was no information on what type and level of support was required. Residents at the home are registered with 6 different GP surgeries and they may keep their own GP if possible. The district nurse services are provided by one of the surgeries and other health care professionals are arranged through GP’s refereals. The home has support of a falls management team who offer advice and support for any residents who are at risk of falls and the home has a continence advisor who is also available. A visiting chiropodist calls on a regular basis and dental checks are arranged through a local health centre and there is a visiting optician service. Residents who completed questionnaires all stated that they were well cared for and that staff were aware of their needs. We looked at medication procedure at the home and all staff who are authorised to administer medication receive appropriate training. The home uses a monitored dose system provided by a local pharmacist and there are clear routines in place for the receipt storage and disposal of medication. Medication administration recording was inspected and these were generally sound, although where instruction on the MAR sheet stated 1 or 2 tablets to be given there was no information recorded on how many tablets had been given each time they were administered and this did not provide a clear audit trail. Staff were observed interacting with residents appropriately and they were seen to treat them with dignity and respect. Staff were heard to use residents preferred form of address when talking to them and staff were seen to knock on residents doors and wait for a reply before entering. Care Homes for Older People Page 13 of 27 Care Homes for Older People Page 14 of 27 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. The home provides a range of activities for resident, which meet their expectations and the religious and recreational interests of residents at the home are provided for. Residents are able to maintain contact with family and friends and visitors are welcome at any time. Residents are supported to exercise choice and control over their lives as much as possible and they are provided with a balanced diet in pleasant surroundings at time convenient to them. Evidence: The home does not have a dedicated activities co-ordinator but one of the care coordinators arranges activities and staff provide additional support for residents who wish to participate. Activities include: arts and crafts, board games, skittles, memory games and quiz’s. Visiting entertainers come to the home and the home keeps a record of all activities and also records whether the residents took part or made an informed decision not to take part. One resident spoken to told us that he enjoyed working in the garden and had planted a number of plants and hanging baskets during the summer. In discussions with residents on the day of the site visit some said they enjoyed taking part in activities while others said they preferred their own company. Staff told us that trips out are occasionally arranged to local country parks and to the Care Homes for Older People Page 15 of 27 Evidence: pub, however residents mainly go out with family. None of the residents at the home attend any form of day service so are reliant on the home for activities. On the day of the visit there was a church service taking place and we were told that this is a regular monthly service. The home has a clear visitors policy and there are no set times, visitors sign in at the home and the visitors book is kept in the hallway, we looked at the visitors book and this showed that there is a regular stream of visitors to the home. We had the opportunity to speak with one relative who was a visitor and they told us they were very happy with the home and said that they were always made welcome and that staff could not do enough for their relative. Residents were observed to be free to choose where and how they spent their time and there were no restrictions imposed upon them. We observed staff supporting residents and it was clear that they were able to make informed choices and are able to control their own lives as much as possible they were given choices regarding the clothes that they wear each day, routines in the home, e.g., times of rising, going to bed, activities, meals, newspapers etc. A number of residents had bought some of their own possessions into the home and rooms had been personalised. The home operates a rolling menu that is changed seasonally and it appeared that residents were very happy with the food provided by the home. Those residents spoken to said that the food was plentiful and good. Residents are offered a choice at meal times and the cook told us that diabetic and special diets are catered for if required. Residents are encouraged to eat their meals in the dining room but may eat elsewhere if they prefer. Lunch on the day of the inspection was Sausage casserole or mince bee and dumplings with fresh vegetables. We observed lunch being taken in the dining rooms and meals were unhurried and staff provided suitable support for residents if needed. The kitchen was well equipped and an environmental health officer conducted an inspection in August 2008 and found that all food hygine arrangements were good. Care Homes for Older People Page 16 of 27 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. There is a simple, clear and accessible complaints procedure, which includes timescales for the process and any complaints are logged and responded to appropriately. The homes policies and procedures protect service users for any form of abuse Evidence: The home has a clear complaints procedure, which contains all of the required information and there is a complains log where any complaints made to the home are recorded, together with the actions taken to investigate and the homes response, however if was not always clear on the date the complaint was received and the date that the complaint was responded to. Residents spoken to said that if they had any concerns they would speak to a member of staff and were confident that any concerns would be dealt with. Staff members spoken to were aware of the complaints procedure and said that they would support any resident to make a complaint if they wished to do so. Staff have received training on adult protection and the home has a whistle blowing policy and also a copy of the Hampshire Adult Protection procedure. Staff spoken to were aware of their responsibilities in this area and knew what to do should they suspect any form of abuse had taken place Care Homes for Older People Page 17 of 27 Care Homes for Older People Page 18 of 27 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. Residents live in a safe and well-maintained environment and have access to comfortable indoor and outdoor facilities. Residents are provided with the specialist equipment they require and the home was clean, pleasant and hygienic and free from offensive odours. Evidence: We conducted a tour of the building and this included all communal areas of the home. The home is laid out in 3 wings, which are all connected and each corridor has contrasting pastel colours and personalised signage on bedroom doors. Each wing had its own small lounge and dining area but residents were free to wander between areas. There was an enclosed rear garden laid to lawn with flower beds and residents had easy access to the garden area. All residents are accommodated in single rooms, which were seen to have varying levels of personalisation, according to taste and preferences. All residents spoken with were pleased with the accommodation. All areas of the home were clean and tidy and furniture was in a good state of repair. The laundry at the home contains 2 industrial washing machines and 2 industrial tumble driers and the home employs dedicated laundry and domestic staff and suitable protective equipment is provided. The home was clean pleasant and hygienic with no unpleasant odours. Care Homes for Older People Page 19 of 27 Evidence: Care Homes for Older People Page 20 of 27 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. Staffing numbers and the mix of staff currently meets the needs of residents and there was a good rapport between residents and staff. residents are protected by the homes recruitment procedures and the home provides training for staff to enable staff to support residents effectively. Evidence: The homes staff rota was examined and this showed that the home provides 2 senior staff members plus 5 carers between 0730 – 1430 and between 21430 – 2130 there were 2 senior staff plus 4 carers and between 2130 – 0730 there is 1 senior staff member and 2 other care staff member awake throughout the night. Staffing numbers were discussed with the care co-ordinators and they told us that they felt that staffing levels were sufficient, however the home will need to continue to monitor staffing levels based on service user needs. The home employs a total of 8 senior care co-ordinators and 20 care staff, and of these all of the care co-ordinators and 19 of the care staff have National Vocational Qualifications and the home was commended for supporting staff to obtain recognised qualifications. The home has policies and procedures in place with regard to recruitment and staff Care Homes for Older People Page 21 of 27 Evidence: recruitment records were inspected for 3 staff members, these contained all of the required information including 2 x references and POVA/CRB checks. The inspector discussed staff training with the visiting manager and she stated that there is a SCC training co-ordinator who arranges training for all of the SCC staff. There is a clear induction based on Skills for Care and this induction is carried within the first 6 weeks. There is a rolling programme of training that is available for staff and this includes: first aid, dementia, manual handling, health and safety, communication, reporting and recording, mental capacity act, challenging behaviour, medication, stroke awareness, falls, basic mental health and diversity. Staff training records showed when training had taken place and when refresher training was required. Staff spoken to and those who returned questionnaires all said that the training provided was very good and that they were provided with the training required to enable them to support residents effectively. Care Homes for Older People Page 22 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management arrangements in place satisfactory, although the manager has been off sick for some time. Quality assurance procedures are in place and service users financial interests are protected by the homes policies and procedures. The health, safety and welfare of residents and staff are protected by the arrangements in the home Evidence: The homes manager has not been available for some time and the day to day management of the home has been undertaken by the care co-ordinators with support from the area manager and the manager of another SCC home who visits the home twice a week. Although this is generally satisfactory there is no one who has been Care Homes for Older People Page 23 of 27 Evidence: identified as having overall responsibility for the day to day management of the home and the providers need to inform us of their intentions regarding this issue. The care co-ordinators said that since the manager has been away no satisfaction surveys have been sent out, however regular resident meetings and staff meetings are taking place to get views on how the home is meeting residents needs. Financial arrangements in the home remain unchanged from previous inspections. The home keeps small amounts of resident’s monies if requested and there are clear recording and receipts of any transaction to provide a clear audit trail. Health and Safety policies are in place and available to all staff members and staff have undertaken training in health and safety. We looked at the homes fire log book and this confirmed that all regular testing takes place and in date certificates were in place for the annual tests of fire alarms system and fire fighting equipment, boilers and gas installations, electrical wiring as well as hoists and lifting equipment. All residents spoken to were happy with the health and safety arrangements in the home and told us that they felt safe at the home. Care Homes for Older People Page 24 of 27 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 25 of 27 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 7 15 The reviews of service users 14/11/2008 plans of care must provide information on how the plan is meeting the service users needs in respect of his health and welfare. This will help to ensure that service users needs are met 2 9 13 Medication administration records must accurately reflect the amount of medication administered on each occasion This will provide a clear audit trail of all administration administered in the home 07/11/2008 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 26 of 27 Helpline: 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 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 © (2008) 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 27 of 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. 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!