Inspection on 07/02/07 for Holderness House

This inspection was carried out on 7th February 2007.

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.

Other inspections for this house

Holderness House 02/12/08

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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Snydale Care Home

Hawkhills

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Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Holderness House 373 Holderness Road Hull East Yorkshire HU8 8QX Lead Inspector Simon Morley Unannounced Inspection 7th February 2007 09:30 X10015.doc Version 1.40 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 Holderness House DS0000000853.V324959.R01.S.doc Version 5.2 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 Older People. 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. Holderness House DS0000000853.V324959.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Holderness House Address 373 Holderness Road Hull East Yorkshire HU8 8QX 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) 01482 702657 holderness.house@virgin.net Holderness House Trust Mrs Wendy Jones Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33) of places Holderness House DS0000000853.V324959.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st November 2005 Brief Description of the Service: 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. 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. The fees are from £347 to £376. The exact amount payable depends on people’s individual financial circumstances. Holderness House DS0000000853.V324959.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector arrived at the home at 9.30 in the morning and left at 5.00 in the evening. He had a look around the home, and chatted with four of the ladies staying at the home. He also talked to six staff, the manager and looked at what staff write down about the ladies they look after. The inspector looked at other records in relation to the management and maintenance of a care home. Questionnaires about the home were sent out to four ladies living there, their relatives and other health and social care professionals involved in their care. Five staff working at the home were also sent a questionnaire. Questionnaires were returned from two staff and one relative. What was said in the questionnaires and what people said during the inspection has been included in this report and used with other information to say how well the home is doing. What the service does well: Staff spoken to were enthusiastic and liked working at the home. They were keen to ensure that residents receive high standards of care. Residents spoken to said they liked the care staff that worked hard to look after them well. More than one resident made comments like ‘they will do anything for you,’ or ‘nothing is too much trouble.’ Residents have a choice from the menu at meal times. Tables are attractively laid and staff serve each resident their choice of meal. The ‘veg of the day’ are served in platters for residents to serve themselves. Residents could also choose where to eat their meals e.g. the dining room, bedrooms or they can entertain guests in the library. Food was described as ‘top notch’. The home has very large and pleasant gardens, which are well maintained. Many of the residents commented that they like to spend time in the garden in good weather. Produce from the garden is also used in the home’s kitchen. The home has continued to publish a newsletter that is popular with the residents. Holderness House DS0000000853.V324959.R01.S.doc Version 5.2 Page 6 There were good staffing and management arrangements to help ensure good quality care is provided. 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. The summary of this inspection report can be made available in other formats on request. Holderness House DS0000000853.V324959.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Holderness House DS0000000853.V324959.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 3. Standard 6 is not applicable. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There were good arrangements to help people choose Holderness House as their home and to ensure they will get good care once they have moved in. EVIDENCE: Residents said they had either visited the home before moving in or that a relative of theirs had done this for them. They confirmed that they were all given a brochure about the home. This includes the services on offer and specific information about the fees they would have to pay, who would have to pay them and what the charges were for any ‘extras’. Holderness House DS0000000853.V324959.R01.S.doc Version 5.2 Page 9 This information was also available in the office for the inspector to see. ‘Extras’ were things like hairdressing, toiletries, newspapers and private chiropody. Residents were more than happy with the quality of the hairdresser. Residents did have the option of visiting a chiropodist at the local health centre and were only charged the extra for a private visit to the home. There was also an additional charge to take residents to pre-arranged hospital visits when their own relatives could not take them. This was to cover the additional staffing costs of the home. Before residents move into the home the manager visits them and completes a good assessment of their care needs. This is to make sure that the care staff will be able to look after them well once they have moved in. The manager also gets copies of other assessment information from health and social care services to help this process. This assessment information is then used to write a care or support plan describing what staff need to do to look after each person. These records were available to be seen as part of the inspection. The quality of assessment records had improved since the last inspection. There were plans to improve these further by introducing a range of detailed risk assessments about people’s dietary needs, skin condition and mobility. This should help to improve further the care people receive. The home does not provide intermediate care, which is a specialist service aimed at maximising people’s independence and return home after a hospital admission. Holderness House DS0000000853.V324959.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Some improvements need to be made to the planning, monitoring and recording of peoples health and personal care needs to ensure everyone gets good consistent care at all times. EVIDENCE: Residents were very complimentary about their care, spoke highly of the staff and manager, and felt they were treated with respect and dignity. They gave some examples of this: staff always knock before they come in our rooms, we get our own post to open and staff are very polite in how they talk to us. It was clear from observation that staff were polite, respectful and patient with the residents. Holderness House DS0000000853.V324959.R01.S.doc Version 5.2 Page 11 Each resident has a written support plan, which gave detailed descriptions of individual care needs and what staff needed to do for each person. Unfortunately one had not been completed and another looked at was not always kept up to date regarding the necessary care to be given. This does put individuals at risk of not receiving good consistent care to meet their needs. This must improve to reduce these risks. In some way this was off set by good communication between staff and staff spoken to were knowledgeable about people’s individual care needs. Residents said they were looked after if they were poorly and got to see the necessary health care professionals e.g. GPs and District Nurses. Care records also showed regular visits to the dentist and optician for those that needed them. Referrals are made to other specialists e.g. dieticians and consultants when there were particular health issues. Although in one particular case a resident had suffered significant weight loss and no referral had been made to a dietician. The manager confirmed a week after the inspection that this had been done. These referrals are important so that residents who need particular health care support get it when they need it to help keep them fit and healthy. There was safe storage of medication and good procedures to make sure residents get the right medication at the right time. Staff responsible for dealing with medication receive the necessary training. Residents said they were happy with the arrangements for getting their medication. Holderness House DS0000000853.V324959.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home tries hard to makes sure that residents get a good quality of daily life. EVIDENCE: Residents said they were satisfied with the range of social events and activities and commented that staff work hard to provide opportunities for everyone. Some residents are fit and healthy and come and go as they wish, making use of local shops and other community facilities. Other residents need more physical help with their care and/or are confused. The two groups tend not to mix with the more able keeping to themselves. This presents a challenge to the home: to meet all the residents’ social, religious and recreational needs. Since the last inspection a part-time activities co-ordinator has been employed to help organise group and individual activities e.g. art and crafts, board games and quizzes. The management team organise film nights, music to movement (gentle exercise), barbecues, organised outings and seasonal celebrations. Holderness House DS0000000853.V324959.R01.S.doc Version 5.2 Page 13 Care records include peoples’ hobbies, interests and religious needs to help staff meaningful experiences for all residents. Based on feedback from residents the library now doubles up as a quiet lounge for those residents wishing to read or look out over the gardens and enjoy some peace and quiet. Activities are held in the main lounge. Some residents had a good knowledge of local churches and said they get visits from them to meet their spiritual needs. Residents said that they liked the visiting arrangements and special arrangements could be made to have meals with visitors either in the dining room or in private. Residents can choose what to eat from the home’s menu. There was a choice of two different main courses each day. The dining room had a pleasant atmosphere with attractively laid tables. Staff served the choice of meal to each resident. Vegetables of the day (grown in the home’s garden) are served on platters for residents to help themselves. Residents said they could also eat in their rooms but are encouraged to make meals a sociable event. One person described the food as ‘top notch’. Residents’ weight was regularly monitored and nutritional supplements were obtained for residents that needed them. Residents who needed it were provided with a range of adapted cutlery and crockery to help them eat independently. Staff discreetly help those residents who need it to eat their food. Based on feedback from residents, seating arrangements have changed to help facilitate this. Holderness House DS0000000853.V324959.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good arrangements to make sure that residents are listened to and kept safe from harm. EVIDENCE: Residents spoken to were full of praise about the home but said they knew how to complain if they felt it necessary. The complaints records clearly showed that residents and their relatives can complain and their complaints are taken seriously. There were 11 recorded complaints since the last inspection covering a range of issues: hot water temperatures, quality of food, care practice, medication, a broken ornament, increase in fees, seating arrangements in the dining room and the flag pole being taken down from the roof and not put back up. These had all been suitably investigated and responded to be either the manager of board of trustees. It was recommended wherever possible that the complainant’s satisfaction with the outcome of their complaint is recorded, this was not always done. The manager and care staff have been trained in recognising abuse and what to do if they witness any abuse so that they can protect the residents from Holderness House DS0000000853.V324959.R01.S.doc Version 5.2 Page 15 harm. Staff were knowledgeable about the procedures for reporting any abusive practice. Holderness House DS0000000853.V324959.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents benefit from the grand and spacious style of the home and wellkept, extensive gardens. The home is well maintained providing a safe environment for residents. EVIDENCE: The home is accessible, set in the heart of a bustling community but set back in its large grounds. There is wheelchair access, which has been improved since the last inspection making it easier for wheelchair users. CCTV has also been installed in the grounds to monitor access and make it safer as there has been some trespassing. Holderness House DS0000000853.V324959.R01.S.doc Version 5.2 Page 17 Residents were pleased with the home and it’s surroundings. They liked the large spacious rooms with good views of the gardens. Work was underway to build a summerhouse to help residents use and enjoy the gardens more. The manager also plans to improve some of the paths in the grounds to help residents and make it safer. There are new blinds and cane furniture in the sun lounge overlooking part of the garden. Residents said they were pleased with this and the blinds help keep the temperature down, as it gets very warm in the sun. The home is well maintained and maintenance certificates were available. The home is clean and smells fresh, there are no malodours. Holderness House DS0000000853.V324959.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There were good staffing arrangements to ensure the health, safety and welfare of the residents. The arrangements for staff training need to improve to ensure all staff are suitably trained. EVIDENCE: Residents said they thought there were enough staff on duty, that they were well trained and did a good job. Staffing levels met the recommended guidance and had been increased since the last inspection. Care staff are supported by the management team, a range of ancillary staff and a new activities co-ordinator to help provide good care and a well run home. The home has slipped below the 50 target of care staff having the required care qualification. The inspector was informed that six members of staff are involved in the NVQ programme with Hull College and when they have completed this will bring the home back up over the 50 . The drop had been Holderness House DS0000000853.V324959.R01.S.doc Version 5.2 Page 19 to due to a small amount of staff turnover, 2 staff retired and 1 left due to personal reasons. The required checks are made on new staff to make sure they are suitable to work in the home and are not likely to harm anyone. Staff said they get good support from the management team and are provided with training to keep their skills up to date and provide good care. Training records were not up to date which made it hard to check if all staff were properly trained. The accuracy of training records was an issue at the last inspection. There need to be accurate and up to date records of all staff training so that any training staff need can be arranged. It is important all staff keep their skills and knowledge up to date to provide good consistent care. Holderness House DS0000000853.V324959.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good management arrangements to make sure residents benefit from a home that is well run and has their interests at heart. EVIDENCE: Residents were very complimentary about the manager and felt that she listened to what they had to say about the home. The current manager is experienced and qualified to run the home well and she undertakes regular training to keep up to date with good practice. Residents are able to make their views known about the service in several ways. There are regular residents’ meetings, and residents are also given Holderness House DS0000000853.V324959.R01.S.doc Version 5.2 Page 21 satisfaction surveys to complete. The manager is approachable and residents quite often make their views known directly to her. Recent improvements to the home: improved wheelchair access, summerhouse, new furniture/décor, setting up a quiet lounge, employing an activities co-ordinator, have been done with residents best interests at heart. A recent audit has been completed and there are plans to improve the interior décor, carpets and window frames. The home only looks after some of the residents’ finances and there were accurate and up to date records kept. Residents spoken to were all happy that they received their full personal allowance or were happy for their relatives to look after their money. Some radiators were not covered and posed a risk to residents from burns; similarly the fire in the quiet lounge had no fireguard to protect residents. This issue was discussed with the manager who explained that risks to residents were not great. She agreed to complete risk assessments and take any action necessary to reduce the risks based on this. Otherwise the home was physically safe and well maintained and maintenance certificates were available for inspection. Holderness House DS0000000853.V324959.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Holderness House DS0000000853.V324959.R01.S.doc Version 5.2 Page 23 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 OP7 Regulation 15 Requirement All residents must have an up to date detailed care plan describing the support they need with all their health, personal and social care needs to help ensure they get good quality consistent care at all times. There must be accurate and up to date records of staff training so that any training staff need can be identified and provided. Risk assessments must be completed for uncovered radiators and unguarded fires and any necessary action identified must be carried out to reduce the risks of burns to residents. Timescale for action 31/05/07 2 OP30 17 and 18 31/05/07 3 OP38 13 31/05/07 Holderness House DS0000000853.V324959.R01.S.doc Version 5.2 Page 24 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 OP3 Good Practice Recommendations Detailed risk assessments regarding dietary needs, skin condition and mobility should be used as soon as possible to help improve the quality of care planning. Holderness House DS0000000853.V324959.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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