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Inspection on 17/08/05 for Holdcroft Road Nursing Home

Also see our care home review for Holdcroft Road Nursing Home for more information

This inspection was carried out on 17th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The service provides care and accommodation for up to six service users requiring nursing care. There was a Statement of Purpose and Service User Guide which provided resident and prospective service users with a clear idea of the service provision. Assessment of need for each individual was detailed; care plans were reflective of the assessment undertaken. The service operates a person centred planning approach to care delivery. The standard of record keeping was good, with evidence of regular review. Additional therapies were offered by the service, by suitably qualified staff. Menu`s showed a varied and balanced diet was provided. The service had a complaints procedure and policy included in the service user guide and displayed in the home. No complaints had been received since the last inspection, although a number of compliments had been received. No adult protection issues had occurred since the last inspection. The standard of staff training was high with all staff having undertaken the mandatory training provided. There were good standards of NVQ training. The care manager had completed the Registered Care Managers Award and had a nursing qualification. The environment was maintained decorated and furnished to a high standard providing good quality surroundings for the service users. All bedrooms were for single occupancy, and exceeded the minimum standards in respect of size. Bathing facilities were of a good standard and provided adapted facilities for the benefit of service users. Policies, procedures and risk assessments were in place, fire safety and servicing documentation was up to date.

What has improved since the last inspection?

The Statement of Purpose and Service User Guide has been reviewed and updated to reflect changes in the staff team. The bathroom has been redecorated. A green house has been purchased for the benefit of eservice users.

What the care home could do better:

The organisation should make the outcome of the annual audit of the service available to the Commission for Social Care Inspection, service users, relatives and other stakeholders. The responsible person should ensure that recruitment records include a previous work history. A risk assessment should be carried out on safe access and use of the green house.

CARE HOME ADULTS 18-65 Holdcroft Road Nursing Home 60 Holdcroft Road Bucknall Stoke-on-Trent Staffordshire ST2 8JL Lead Inspector Ms Wendy Jones Announced Inspection 17th August 2005 12:00 Holdcroft Road Nursing Home DS0000026950.V260039.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Holdcroft Road Nursing Home DS0000026950.V260039.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Holdcroft Road Nursing Home DS0000026950.V260039.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Holdcroft Road Nursing Home Address 60 Holdcroft Road Bucknall Stoke-on-Trent Staffordshire ST2 8JL 01782 570323 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Choices Housing Association Limited Ms Elizabeth Ann Brown Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Holdcroft Road Nursing Home DS0000026950.V260039.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th March 2005 Brief Description of the Service: 60 Holdcroft Road is a six bedded purpose built bungalow situated in the Bucknall area of Stoke-on-Trent. The property is owned by a housing association and care provided by Choices. The home offers six single rooms, none of which have ensuite. Communal areas include a lounge and separate dining room which is adjacent to the kitchen. There is an assisted bathroom with toilet and a separate walk in shower room. The home also has a separate utility area and there is a garden space to the rear or the property. A glasshouse is in the process of being constructed which will be wheelchair accessible. There is parking for three vehicles to the front on the property. Holdcroft Road Nursing Home DS0000026950.V260039.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection carried out on the 17 August 2005. Information for the inspection was provided from discussion with the manager and staff; the pre inspection questionnaire; written feedback from relatives; inspection of the care records, the environment and other documentation pertinent to the inspection process; observation of the interactions between care staff and service users. During this inspection there were five service users in residence, four gentlemen, one lady ages ranged from 68 years to 42. One of the service users was on holiday. Dependency levels were high, all were wheelchair users, all required assistance with dressing, undressing, washing and bathing. All required, two staff to assist with personal care, all had nursing care needs. Effective communication was an issue, the service used a number of methods to ensure that service users were involved with day to day decision making, including picture referencing. What the service does well: The service provides care and accommodation for up to six service users requiring nursing care. There was a Statement of Purpose and Service User Guide which provided resident and prospective service users with a clear idea of the service provision. Assessment of need for each individual was detailed; care plans were reflective of the assessment undertaken. The service operates a person centred planning approach to care delivery. The standard of record keeping was good, with evidence of regular review. Additional therapies were offered by the service, by suitably qualified staff. Menu’s showed a varied and balanced diet was provided. The service had a complaints procedure and policy included in the service user guide and displayed in the home. No complaints had been received since the last inspection, although a number of compliments had been received. No adult protection issues had occurred since the last inspection. The standard of staff training was high with all staff having undertaken the mandatory training provided. There were good standards of NVQ training. The care manager had completed the Registered Care Managers Award and had a nursing qualification. Holdcroft Road Nursing Home DS0000026950.V260039.R01.S.doc Version 5.0 Page 6 The environment was maintained decorated and furnished to a high standard providing good quality surroundings for the service users. All bedrooms were for single occupancy, and exceeded the minimum standards in respect of size. Bathing facilities were of a good standard and provided adapted facilities for the benefit of service users. Policies, procedures and risk assessments were in place, fire safety and servicing documentation was up to date. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Holdcroft Road Nursing Home DS0000026950.V260039.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Holdcroft Road Nursing Home DS0000026950.V260039.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 and 4. The homes Statement of Purpose and Service User Guide are excellent providing service users and prospective service users with details of the services the home provides enabling an informed decision about admission to be made. EVIDENCE: The service had a Statement of Purpose and Service User Guide. Since the last inspection a review had taken place, to ensure that both documents accurately reflected the staff teams. Information seen provided prospective service user with information regarding the facilities and service provided. A sample of assessments undertaken prior to and since admission were inspected and found to be satisfactory. The manager confirmed that the new service user had opportunities to visit the service prior to moving in and gave examples of these visits. Holdcroft Road Nursing Home DS0000026950.V260039.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8 and 9. The standard of care planning was high, with evidence that service users assessed needs were being met. The records showed that service user were included and supported in decision making in the home. EVIDENCE: The standard of care planning, assessment and review was high throughout and daily records gave a satisfactory account of how the care needs of service users were being met. The 24 hour plans of care gave staff a good insight in to the service users preferred routine and the assistance they required. The service uses a person centred approach to care planning which places the service user firmly at the centre of the process and where possible ensures that service users are consulted and involved in the planning and reviews of care. Holdcroft Road Nursing Home DS0000026950.V260039.R01.S.doc Version 5.0 Page 10 Individual risk assessments were an integral part of the care planning process, and like care plans had been reviewed regularly. There was also evidence of multi disciplinary working and agreement. Holdcroft Road Nursing Home DS0000026950.V260039.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 14, 16 and 17. Dietary needs of service users are well catered for with a balanced and varied selection of food available that meets service users tastes and choices. EVIDENCE: A sample of activity and occupational records were seen, these included the known, preferred participation options of the individual and a list of activities to try. Staff record when a service user has been engaged in an activity, night staff calculate the numbers of activities recorded and the frequency of activities on a weekly basis. On a monthly basis this information is collated and forms part of a quality audit for the service. There was some discrepancy between the figures given for some activities and the information regarding service user activity in individual care records and diaries. An example included, one day where 19 activities had been calculated, but in the diary there was only 11 activities recorded. This was discussed with the manager, who agreed to discuss the criteria for calculation with staff and Holdcroft Road Nursing Home DS0000026950.V260039.R01.S.doc Version 5.0 Page 12 remind staff to ensure that they had recorded all activities service users were engaged in. One service user was on a short holiday, two others had plans to go away, one service user had enjoyed a holiday. The newest service user was to have a holiday arranged once finances had been sorted out. The records showed that service users were offered a well balanced and varied diet the service had further promoted good practice, by producing pictorial choices for service users. The meal times demonstrated a flexible approach. Food stocks were good, and basic food hygiene standards were maintained. Holdcroft Road Nursing Home DS0000026950.V260039.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 and 21. The health, emotional and personal care needs of service users are well met with evidence of good multi disciplinary working taking place on a regular basis. The medication at this home is well managed promoting good health. There was evidence that the service had considered the needs of service user in respect of ageing, illness and death. EVIDENCE: Service users health care needs were being appropriately met, assessments of health care needs had been carried out, and records showed how health care needs were being monitored and met, with evidence of attendance for regular health appointments. All service users were registered with local G.P. services and received primary and specialist health care. The records showed a good level of multi disciplinary working. The expertise of staff was recognised during this visit. There was evidence of specialist training including epilepsy, aromatherapy, bereavement care. Holdcroft Road Nursing Home DS0000026950.V260039.R01.S.doc Version 5.0 Page 14 The systems for the administration of medication were satisfactory, records were appropriately maintained, protocols for the administration of as required medication were in place. There was evidence of involvement from the dispensing pharmacist; stock control systems were good, a record of staff signatures was included in the medication file. There was very good practice in relation to the information available to staff regarding the purpose and effects of medication. A homely remedies list had been agreed with the prescribing GP. Aromatherapy treatments had also been agreed. Medication was administered only by qualified nursing staff. The organisation has produced information to support service users with bereavement, in co-operation with a local support service and in consultation with service users. Records showed that relatives had been consulted regarding their wishes and preferred arrangements in the event of death. Holdcroft Road Nursing Home DS0000026950.V260039.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 The home has a good complaints system with evidence that service users feel that their views are listened to and acted upon. EVIDENCE: No complaints had been received since the last inspection and none had been received by the Commission for Social Care Inspection. Relatives had identified in feedback questionnaires that they knew how to complain if they felt the need to. As discussed at previous inspections the service operates a whinge box, where staff can post grumbles or minor concerns, these are then discussed at staff meetings and resolved. Holdcroft Road Nursing Home DS0000026950.V260039.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27, 28, 29 and 30. The appearance of this home created a comfortable and safe environment for those living there and those visiting. Facilities were adapted and sufficient for the needs of service users. EVIDENCE: The standard of environment throughout was very high, well maintained, decorated and furnished. A sample of bedrooms demonstrated that service users had been supported to choose colour schemes that reflected their gender and had been supported to take ownership of their space. All bedrooms were for single occupancy, all exceeded the minimum standards in terms of size, none had en-suite facilities. Communal space was satisfactory; all areas of the home were clean. The service provides a pleasant lounge and a separate dining room with additional comfortable seating. The kitchen is open plan of domestic style and accessible to service users. Holdcroft Road Nursing Home DS0000026950.V260039.R01.S.doc Version 5.0 Page 17 Since the last inspection the bathroom has been improved and transformed into a sensory bathroom where service user can enjoy a relaxing experience. Specialist equipment and adaptations were available for the benefit of service users throughout the home. There was ramped access to the pleasant garden area, that had raised garden beds and a green house with wheelchair access has been purchased since the last inspection from donations to the home. It was confirmed that safety glass had been provided. Holdcroft Road Nursing Home DS0000026950.V260039.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35. Staff morale is high resulting in an enthusiastic workforce that works positively with service users to improve their whole quality of life. EVIDENCE: The staffing arrangements on the day of this visit, included the manager 10am-6pm, two staff 7.30am-3pm, one staff 9.30am-1.30pm and a student nurse 7.30am-3pm. Other staff included one x 2pm-9.30pm, one x 1.30pm-9.30pm, one x 3pm8.30pm and night staff including one x 9.15pm-7.30am and an agency staff 9.15pm-7.30am. The service had struggled to maintain regular staff due to long tern sickness, and 67.5 hours staff vacancies. The deficit had been made up with agency staff, the manager stated that they used the same agency staff as often as they could to ensure consistency. Five staff had achieved National Vocational Qualification level 2, one was working towards level 3, the manager was a qualified nurse and aromatherapist and had achieved the Registered Care Managers award. Holdcroft Road Nursing Home DS0000026950.V260039.R01.S.doc Version 5.0 Page 19 Information in the pre inspection questionnaire and from the manager indicated that staff had received mandatory and supplementary training. Staff recruitment records were satisfactory with evidence that appropriate checks had been carried out, with the exception of one, from the sample seen. The care manager addressed this before the report was completed. It was also recommended that the application form should be maintained on the file of staff, as an indicator of previous experience and work history. Holdcroft Road Nursing Home DS0000026950.V260039.R01.S.doc Version 5.0 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 40, 42. The service was well managed, with a qualified and competent manager. Health and safety of service users was assured, by thorough risk assessment and good policies and procedures. EVIDENCE: The manager was a qualified nurse and had undertaken the Registered Care Managers Award. She had many years experience in the care of service user with learning disabilities; she was also a qualified aroma therapist. The service had undertaken a quality audit of the service, including canvassing comments from relatives and other stakeholders. The outcome of the audit and the plan of action for the next twelve months should be made available for inspection purposes. Holdcroft Road Nursing Home DS0000026950.V260039.R01.S.doc Version 5.0 Page 21 Risk assessments were in place individual service users and for more general risks, it was required that a risk assessment must be undertaken in relation to the use and access to the greenhouse. Fire safety documentation was satisfactorily maintained, with evidence of fire drills, fire safety checks and fire training. A recent change in the evacuation procedure had been agreed, in co-operation with fire safety services. Regular checks of hot and cold water temperatures were recorded following a requirement of the last inspection. Portable appliance testing was up to date. Holdcroft Road Nursing Home DS0000026950.V260039.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 4 3 x 3 x Standard No 22 23 Score 4 x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 4 3 3 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 4 3 x 3 3 3 3 LIFESTYLES Standard No Score 11 x 12 3 13 X 14 2 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 3 3 3 x CONDUCT AND MANAGEMENT OF THE HOME 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Holdcroft Road Nursing Home Score 4 3 4 4 Standard No 37 38 39 40 41 42 43 Score 4 3 X 3 X 2 X DS0000026950.V260039.R01.S.doc Version 5.0 Page 23 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA39 Regulation 24 Requirement The outcome of the annual quality audit and development plan must be made available to service users the CSCI A risk assessment must be undertaken in relation access and use of the greenhouse. Timescale for action 17/11/05 2 YA42 13 17/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA34 Good Practice Recommendations The recruitment records of staff should include a record of their previous work history. Holdcroft Road Nursing Home DS0000026950.V260039.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Holdcroft Road Nursing Home DS0000026950.V260039.R01.S.doc Version 5.0 Page 25 - 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. 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