Inspection on 02/12/08 for Holderness House

This inspection was carried out on 2nd December 2008.

CSCI 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

Holderness House 07/02/07

Holderness House 01/11/05

Holderness House 12/05/05

Holderness House 26/10/04

Holderness House 17/06/04

Holderness House 18/02/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 29/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Holderness House 373 Holderness Road Hull East Yorkshire HU8 8QX     The quality rating for this care home is:   two star good 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: George Skinn     Date: 0 2 1 2 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 26 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 26 Information about the care home Name of care home: Address: Holderness House 373 Holderness Road Hull East Yorkshire HU8 8QX 01482702657 Telephone number: Fax number: Email address: Provider web address: hhtrust@hhtrust.karoo.co.uk Name of registered provider(s): Name of registered manager (if applicable) Mrs Wendy Jones Type of registration: Number of places registered: Holderness House Trust care home 33 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Holderness House is a care home registered to provide personal care and accommodation for up to 33 people over the age of 65. Holderness House Trust run the home. It is a charitable trust set up by a local Victorian industrialist and philanthropist. In the terms of his will the home only offers care to ladies, gentleman are not admitted. Holderness House is a large 19th Century mansion house set in extensive grounds on Holderness Road, about two miles from the centre of the city of Kingston upon Hull. The original building is believed to be a Grade II listed building. There is also a purpose-built extension. The home is set in the heart of a bustling community: There is a wide range of shops, churches, clubs and pubs close by. There is a bus stop very close to the home. The home provides spacious accommodation in single rooms on three floors. Almost all have en suite WC and wash hand basin facilities, whilst a few also have a shower or bath. There is a very pleasant lounge, a large dining room and a quiet lounge / library, which can also be used for meetings. Care Homes for Older People Page 4 of 26 0 Over 65 33 Brief description of the care home There is a passenger lift with access to all three floors. There are very pleasant, large and well-kept gardens to which adaptations have been made to allow access for wheelchair users. There is also ample parking space for visitors. Information about the home is available on request, in the main hallway and is sent out to all people enquiring about vacancies. Care Homes for Older People Page 5 of 26 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: The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. The key inspection has used information from different sources to provide evidence. These sources include Reviewing information that has been received about the home since the last inspection Information provided by the registered person on an Annual Quality Assurance Assessment AQAA Care Homes for Older People Page 6 of 26 Comment cards returned from people who live at the home relatives and staff A visit to the home carried out by one inspector A site visit was carried out which lasted 7 hours. We spoke with the people who live at the home, their relatives and staff and we looked at records relating to the people who live at the home staff and the management activities of the home. During the visit care practices were observed, where appropriate, and time was also spent watching the general activity within the home. We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future if a requirement is repeated it is likely that enforcement action will be taken. Date of last inspection 07/02/07 The manager was available to assist throughout the day. The current weekly fee is 370 pound per week including a 20 pound top up charge. What the care home does well: What has improved since the last inspection? What they could do better: Before someone moves into the home their needs should be assessed by who ever is making the referral for example the Social Service. This assessment should be at the home before the person moves in so the home can decide if they can meet the persons needs. This is not always done and this means that the home can not make a judgment about if they can meet that persons needs. The home needs make sure that any information which kept about people who live at the home is kept up to date and represents that persons current needs and shows any changing needs. This will help the staff to care for that person better and provide the care which they need. The home need to make sure that all the staff have had the proper safety training and that they know when this needs updating. This will make sure that all the people who live at the home are safely cared for and the staff do not injure themselves or the Care Homes for Older People Page 8 of 26 people who live at the home. 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 printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 26 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 26 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. People who move into the home do not alway have their needs assessed prior to moving by the placing authority. Evidence: We looked a sample of files which belonged to the people who live at the home. This included those people who had live at the home for a while and those who had just moved in recently. We saw that the home had not obtained an assessment for one person who had moved in recently. This is essential as the home do not know what the needs of the person are and cannot formulate their own care plans about how to meet those needs effectively without this. The manager told us that she has had some problems with obtaining assessments and care plans especially from the hospital. She also told us that she does her own assessments prior to the person moving into the home so she can establish if the home can meet the persons needs. Care Homes for Older People Page 11 of 26 Evidence: We saw that the homes registration needs up dating to include those people who have dementia. The home does not provide intermediate care which is a specialist service aimed at maximising peoples independence and return home after a hospital admission. Care Homes for Older People Page 12 of 26 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. All the people who live at the home have a care plan but these are not always up to date or reflect the persons changing and current needs. People are protected by the way the home handles medication and staff treat people with dignity and respect. Evidence: We looked at a sample of files which belonged to the people who live at the home. These file belonged to a range of people including those who are dependent on the staff for help and personal assistance, those who are independent and those who have recently moved into the home. At the last inspection it was noted that some of the care plans had not been up dated and were long over due for re-evaluation; this was still found to be the case during this inspection. We saw that the quality of the recording was variable and some files had been completed accurately and reflected the persons current needs. Others were Care Homes for Older People Page 13 of 26 Evidence: out of date and did not provide a good picture of the persons current or changing needs. The care plans contained generic risk assessments and it was not clear on all the plans looked at when these had been updated or changed. We saw that the daily notes were detailed and indicated when people had seen their GP or district nurse and when their needs had changed, however this information was not always transferred into the care plans. The manager has sourced a new care planning system and she is confident that this will address any short comings in the present system she is intending to introduce this before Christmas and the staff will receive full training. We looked at the medication system in the home and found no issues. The staff make sure that correct medication has been supplied by the pharmacist when it is delivered and any mistakes are quickly rectified. The staff make sure that the recording of the medication is up to date and gives a clear indication that the medication has been administered. The recording also indicates when the medication has not been given and why. All of the staff who give out medication have had the proper accredited training and we saw certificates which confirmed this. When we spoke with the staff they were clear about how to maintain some ones dignity and uphold their rights. We saw that the staff were sensitive to peoples needs when undertaking any personal tasks and were sensitive and patient when dealing with those people who have dementia. At no time did we hear any of the staff using any derogatory language or belittling any one in any way. The people who live at the home told us they were more than happy with the standard of care which they received, one person told us that the girls are wonderful and very caring. Care Homes for Older People Page 14 of 26 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 who live at the home are able to take part in age appropriate activities and are encouraged and enabled to exercise choice in their daily lives. The people who live at the home can maintain contact with relatives and friends and can participate in activities in the local community. The people who live at the home receive a well balanced and nutritional diet. Evidence: When we spoke with the people who live at the home they said they could make choices about activities, food, how to spend their time and when to get up and go to bed. The home encourages contact with relatives and friends. We saw that visitors were made welcome to the home and had good relationships with the staff; the manager told us that one persons daughter had stayed at the home when visiting her mother. We saw that a selection of activities are arranged for the people who live at the home to take part in if they wish; these included reminiscence, one to one discussions, Care Homes for Older People Page 15 of 26 Evidence: bingo, quizzes, table games, dominoes, crosswords and nail care. Advertisements around the home told us that that entertainers visit regularly and during the summer months trips out are booked weather permitting. When we spoke with the people who live at the home about the food they told us it was very good and there is plenty of choice. Lunch on the day of the inspection was nicely presented and looked wholesome and nutritious, there is a choice of two courses every day for lunch. Staff helped those people who required assistance when eating in a relaxed unhurried manner. When we spoke with the cook she was knowledgeable about peoples diets and had received the appropriate training. The home have recently been awarded an A for the cleanliness of the kitchen by the local Health and Safety inspectors. Care Homes for Older People Page 16 of 26 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 are protected by the homes policies and procedures on how to handle complaints. Staff are aware of how to protect someone from harm but need more training. Evidence: The home have received six internal complaints in the last twelve months. These had been fully recorded and the satisfaction of the complainant with the outcome recorded. The CSCI has not received any complaint or concerns about the home since the last inspection and the home have not been the subject of any Safeguarding Adults investigation by the local authority. The home have a policy and procedure for the staff to follow if they do have to make any Safeguarding Adults referrals. The staff were aware of this policy and were able to describe it when asked. When we spoke with the staff they were able to tell us what they would do if they witnessed any abuse within the home or anyone made any allegation to them. Not all of the staff have had formal Safeguarding Adults training. Care Homes for Older People Page 17 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live a well maintained comfortable environment. Evidence: The home provides spacious accommodation in single rooms on three floors. Almost all have en suite WC and wash hand basin facilities whilst a few also have a shower or bath. There is a very pleasant lounge a large dining room and a quiet lounge library which can also be used for meetings. There is a passenger lift with access to all three floors. There are very pleasant large and well kept gardens to which adaptations have been made to allow easy access for wheelchair users. There is also ample parking space for visitors. The home is accessible set in the heart of a bustling community but set back in its own large grounds. Close Circuit TV has also been installed in the grounds to monitor access and make it safer as there has been some trespassing. People who live at the home were pleased with the home and its surroundings. They liked the large spacious rooms with good views of the gardens. Care Homes for Older People Page 18 of 26 Evidence: The home has a summerhouse at the front to help people use and enjoy the gardens more. The home is well maintained and maintenance certificates were available. The home is clean and smells fresh there are no malodours. Care Homes for Older People Page 19 of 26 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. People are cared for by staff who are provided in enough number to meet their needs. The people who live at the home are protected by the home recruitment and selection policies and procedures. People who live at the home need to be confident that they are cared for by staff who are well trained and competent to do so. Evidence: There is a satisfactory staff rota in place that records the role of each member of staff. The staffing levels are based on the needs of the people who live at the home. There is a cook on duty each day as well as a kitchen assistant and other ancillary staff; this enables care staff to concentrate on assisting people with personal and social care activities. Training records indicated that that more than 50 of the staff are trained to NVQ level 2 which includes training on equality and diversity and an awareness of abuse. The recruitment and selection procedures remain robust and all checks are undertaken prior to staff commencing work at the home. The staff files looked at contained references from previous employer, an application form which identified gaps in employment and a completed Criminal Record Bureau (CRB) check. Care Homes for Older People Page 20 of 26 Evidence: Records that we saw indicated that the home need to up date the staffs mandatory training this includes health and safety, moving and handling, first aid, fire and basic food hygiene. We also saw that the staffs supervision has not been done for some time and staff training needs are not being identified and addressed. It is strongly recommended that the home do full audit of staff training to establish a base line for development and monitoring of staff training needs. Care Homes for Older People Page 21 of 26 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. People live in a home which is run in their best interests. Due to some of the staffs mandatory training needing updating the health and safety of the people who live at the home and the staff is not fully protected. Evidence: The manager is registered with the CSCI and has the relevant qualifications and experience for this role. People who live at the home told us that the management are approachable and they have confidence in them. Staff told us that the management is supportive and provides them with good leadership. From speaking to the manager and staff it is clear that the homes ethos is to promote participation and inclusion for the people who live at the home. The home continues to have a well developed quality assurance system that involves the people who live at the home, carers, family staff and other professionals like Doctors and nurse; giving their views about the home. Surveys are completed throughout the year and an annual Care Homes for Older People Page 22 of 26 Evidence: report is produced explaining the outcome of the surveys and any relevant action to be taken. People who live at the homes and/or their families continue manage their own financial affairs; some personal monies are kept by the home we saw that these were recorded accurately and the people are protected by the homes handling of their money. The home has a fire policy and the fire risk assessment was being updated following the fitting of new fire alarm system; the fire alarm is tested weekly. Tests on equipment are undertaken and fire drills are carried out on a monthly basis. The home has a nurse call system fitted to ensure that all the people who live at the home are able to request assistance. All the equipment in the home is tested at the appropriate intervals and all maintenance certificates are up to date. The AQAA which was returned by the home prior to the site visit was well completed and told us about identified areas for improvement. We saw that not all of the staffs mandatory training is up to date, this means that the health, welfare and safety of the people who live at the home is fully protected. Care Homes for Older People Page 23 of 26 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 24 of 26 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 3 The home should make sure they have obtained a thorough assessment undertaken by the placing authority prior to the person moving into the home. This will ensure they can meet the persons needs effectively. The manager should make sure that all of the care plans in place for the people who live at the home reflect the current and changing needs of that person. The manager should evaluate the staff training with regard to Safeguarding Adults and provide more training where needed. The manager should do full audit of staff training to establish a base line for development and monitoring of staff training needs. The home needs to establish a system of check when the staffs mandatory training needs up dating. 2 7 3 18 4 30 5 38 Care Homes for Older People Page 25 of 26 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 26 of 26 - 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!