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Inspection on 27/01/06 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 27th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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. 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. The personal and health care needs of service users were appropriately met. The systems for the safe administration of medication were satisfactory. Menus showed a varied and balanced diet was provided. No adult protection issues had occurred since the last inspection. Policies and procedures were in place for safeguarding service users. The environment was maintained and furnished to a good standard, providing good quality surroundings for the service users. Bathing facilities were of a good standard and provided adapted facilities for the benefit of service users. Staffing levels were sufficient for the needs of service users. Policies, procedures and risk assessments were in place and fire safety checks had been carried out and recorded.

What has improved since the last inspection?

The service had recruited a full staff team. Previous requirements and recommendations have been met.

What the care home could do better:

Ensure that all staff are involved in fire drills and fire training. Potentially hazardous substances must be stored as required by regulation.

CARE HOME ADULTS 18-65 Holdcroft Road Nursing Home 60 Holdcroft Road Bucknall Stoke-on-Trent Staffordshire ST2 8JL Lead Inspector Ms Wendy Jones Unannounced Inspection 27 January 2006 18:30 Holdcroft Road Nursing Home DS0000026950.V280507.R01.S.doc Version 5.1 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.V280507.R01.S.doc Version 5.1 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.V280507.R01.S.doc Version 5.1 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.V280507.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th August 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 are en-suite. 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 walkin shower room. The home also has a separate utility area and there is a garden to the rear of the property. There is parking for three or more vehicles to the front of the property. Holdcroft Road Nursing Home DS0000026950.V280507.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection conducted on 27th January 2006. Information for the report was gathered from discussion with staff; conversation with service users; observation of interactions; inspection of care records and other documentation relevant to the inspection process. During this inspection there were six service users in residence: four gentlemen and two ladies, ages ranged from 43 to 77 years. What the service does well: What has improved since the last inspection? The service had recruited a full staff team. Previous requirements and recommendations have been met. Holdcroft Road Nursing Home DS0000026950.V280507.R01.S.doc Version 5.1 Page 6 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.V280507.R01.S.doc Version 5.1 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.V280507.R01.S.doc Version 5.1 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): EVIDENCE: These standards were not inspected during this visit. Holdcroft Road Nursing Home DS0000026950.V280507.R01.S.doc Version 5.1 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 There was a clear and consistent care planning system in place to provide staff with the information they need to satisfactorily meet service users’ needs. EVIDENCE: The standard of care planning was high and regular reviews were carried out. Person-centred planning was in place. Staff stated that a new format was being introduced and work was underway to transfer information for this more user-friendly model. 24-hour plans of care provided staff with a clear account of service users’ preferred routines and care needs. Risk assessments were also in place. Each service user was allocated a named nurse and key worker. A service user had been admitted since the last inspection: the records of preadmission assessment were not available from those seen, and it was unclear from the records seen if the service had confirmed that it could meet the needs of the service user. The manager contacted the Commission for Social Care Inspection following the inspection to confirm that the information was included in the individual care records. Holdcroft Road Nursing Home DS0000026950.V280507.R01.S.doc Version 5.1 Page 10 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): 13, 14, 17 Links with the community were adequate and appropriate leisure and recreational opportunities provided. 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: Each service user had a participation options list which gave an idea of the type of activities the individual engaged in usually. Other choices could be added to the list. Staff recorded every activity undertaken during the day and the results were assessed and analysed to inform quality audits of the service delivery. From the sample seen there was evidence that service users accessed the local community, albeit occasionally - which could be attributed to the time of the year and inclement weather. This inspection did not include observation of a mealtime. Holdcroft Road Nursing Home DS0000026950.V280507.R01.S.doc Version 5.1 Page 11 Menu records showed that service users were offered a well-balanced and varied diet. The file contained recipes for some meals and shopping lists to assist staff with budgeting. Pictorial meal choices had been produced for service users to assist them to make a choice of main meal. Food stocks were good. Fridge/freezer and hot food temperatures were recorded daily. Holdcroft Road Nursing Home DS0000026950.V280507.R01.S.doc Version 5.1 Page 12 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): 19, 20. 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. EVIDENCE: A sample of health care records showed that service users accessed ordinary health care services such as GPs and dental services. Referrals had been made to specialist healthcare services. Health care needs were monitored in the home on a very regular basis with good record keeping and evidence that issues were followed through. Fluid balance, blood sugar and bowel management were recorded daily for those service users with specific health needs. All service users had a learning disability and all had some mobility difficulties. Two service users used wheelchairs at all times. Procedures for the safe administration of medication were in place, the records of administration were appropriately maintained, and there was clear instruction given in relation to the route of administration of some medications. Holdcroft Road Nursing Home DS0000026950.V280507.R01.S.doc Version 5.1 Page 13 Regular medication reviews were undertaken. Protocols for the administration of as-required medication had been agreed and a home remedy list and the use of aromatherapy treatments had been agreed with the G.P. Holdcroft Road Nursing Home DS0000026950.V280507.R01.S.doc Version 5.1 Page 14 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): 23 Arrangements for protecting service users were satisfactory, limiting the possible risk of harm or abuse. EVIDENCE: There were policies and procedures in place for safeguarding service users, recognising and reporting abuse. No Vulnerable Adults issues have been referred under Vulnerable Adults procedures. Holdcroft Road Nursing Home DS0000026950.V280507.R01.S.doc Version 5.1 Page 15 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, 27, 30 This home provided a comfortable and safe environment for those living there and visiting, but would benefit from redecoration in some of the communal areas. EVIDENCE: The bungalow is situated in a residential area with borders on a hospital site. The driveway provides ample parking space. Motion-sensitive security lighting had been installed at the front of the building. This inspection did not include a detailed inspection of the environment. The home was clean, tidy and homely throughout although there was evidence that some communal areas would benefit from painting or redecorating in parts. 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. Bathing/shower and toilet facilities were sufficient for the service users. Holdcroft Road Nursing Home DS0000026950.V280507.R01.S.doc Version 5.1 Page 16 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): 33 Staff morale is high resulting in an enthusiastic workforce that works positively with service users to improve their whole quality of life. EVIDENCE: Staffing included 1x 1x 1x 1x 1x 7.30am-2.30pm 9.30am-4.30pm 7.30am-4.30pm 1pm-9.30pm 1.30pm-9.30pm There were 2 waking night staff, and 1 member of staff per shift was a qualified nurse. Since the last inspection the service had recruited a full staff team. Discussion with staff on duty showed that they were knowledgeable about the care needs of service users. Holdcroft Road Nursing Home DS0000026950.V280507.R01.S.doc Version 5.1 Page 17 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): 39, 42 The management of this home was good but there were some areas that could be improved for the benefit of service users. EVIDENCE: The records showed that a relatives’ survey had been carried out since the last inspection, and it was understood that the information would be used to inform a quality audit and development plan for the home’s annual plan. The manager contacted the Commission for Social Care Inspection following this inspection to confirm that an annual development plan would be available from the 31st March 2006. Records showed that regular fire drills had occurred in the home - in excess of the minimum required. Most staff had been involved with a fire drill at some point, but according to the records from July 2005 three staff had not taken part in a drill and 6 staff had been involved in one drill. In addition the records available showed that 3 staff had not received fire training, but planned training dates were in place. Holdcroft Road Nursing Home DS0000026950.V280507.R01.S.doc Version 5.1 Page 18 Fire safety checks were carried out and recorded regularly. Risk assessments were in place for individuals and for general environmental risks, all of which were reviewed on a regular basis. The storage facilities for cleaning solutions was unlocked. There was discussion with staff in relation to the risk to service users and a requirement made that the main storage facility is locked at all times. A risk assessment is to be undertaken about the storage of solutions that are used on a day-to-day basis. Holdcroft Road Nursing Home DS0000026950.V280507.R01.S.doc Version 5.1 Page 19 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 Standard No Score 1 X 2 x 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X X X LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 X 16 X 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x 3 3 3 x X 3 X X 2 X Holdcroft Road Nursing Home DS0000026950.V280507.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? No 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 YA42 Regulation 13 Requirement The registered person shall comply with Health and Safety requirements relating to the safe storage of hazardous substances. All staff must be included in regular fire drills and training. Timescale for action 27/02/06 2 YA42 23(4) 27/03/06 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 YA42 Good Practice Recommendations Carry out a risk assessment in relation to the storage of cleaning solutions for daily use. Holdcroft Road Nursing Home DS0000026950.V280507.R01.S.doc Version 5.1 Page 21 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.V280507.R01.S.doc Version 5.1 Page 22 - 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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