Inspection on 01/11/05 for Holland House

This inspection was carried out on 1st November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Holland House 16/11/07

Holland House 08/08/06

Holland House 18/04/05

Holland House 12/08/04

Holland House 26/04/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Holland House Holland House Coulsdon Road Caterham Surrey CR3 5YA Lead Inspector Mary Williamson Announced Inspection 1st November 2005 10:30 Holland House DS0000013676.V253741.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 Holland House DS0000013676.V253741.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. Holland House DS0000013676.V253741.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Holland House Address Holland House Coulsdon Road Caterham Surrey CR3 5YA 01883 383715 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) Surrey Oaklands NHS Trust Mrs Dennies Donicia Ward Care Home 10 Category(ies) of Learning disability (3), Learning disability over registration, with number 65 years of age (7) of places Holland House DS0000013676.V253741.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The age/age range of the persons to be accommodated will be: 45-65 (3 OF WHOM MAY BE OVER 65 YEARS OF AGE) 18th April 2005 Date of last inspection Brief Description of the Service: Holland House is owned by Surrey and Borders Partnership NHS Trust and is located in the of a former hospital site. It is one of a group of purpose built bungalows on this site and is designed to accommodate up to ten service users with a learning disability. Accommodation includes ten single bedrooms without en-suite facilities. There is also a large lounge, a smaller quiet lounge, a dining room, and ample toilet and bathroom facilities. The bungalow is set in its own grounds with its own garden and patio area. There is easy access to the local community facilities. The home has its own transport. Holland House DS0000013676.V253741.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and the second inspection in The Commission for Social Care Inspection year 2005/2006. Mary Williamson the Lead Inspection for the home undertook the inspection. It was carried out over a period of five hours. All the service users had a day off and were spending some time at home. There was the opportunity to meet and talk with all the service users, some in more detail than others due to communication skills. All the staff on duty were spoken to who all made a positive contribution to the inspection. Nine service user comment cards were received. These are in symbol format and the service users were supported to complete these outside the home. Three health care professional comment cards were also received. All had positive feedback. There were no visitors in the home during the inspection. A tour of the premises was undertaken and records relating to the care of the service users and the management of the home were examined. There was a relaxed and homely atmosphere noted with staff interacting in a caring and supportive manner with the service users. Staff have the communication skills necessary to communicate effectively with the service users. The inspector would like to thank the service users, and staff for their hospitality and positive contribution to the inspection process. What the service does well: The staff team have a sound knowledge of the care needs of the service user in their care. Service users are supported in accommodation, which is well maintained and comfortable. Individual care plans are detailed and reflect the care being provided. Holland House DS0000013676.V253741.R01.S.doc Version 5.0 Page 6 Service users are supported to take part in a variety of activities both in the community and at home. 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. Holland House DS0000013676.V253741.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 Holland House DS0000013676.V253741.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 and 2. A statement of purpose and service user service user guide is in place. Preadmission needs assessments are also in place. EVIDENCE: Since the last inspection the service users guide and statement of purpose have been updated and a copy available to all service users. Needs assessments are in place and are reviewed regularly to address individual changing needs. There have been no recent admissions to the home. The manager stated that she would undertake the pre admission needs assessment and would discuss this with the senior management team to establish the suitability of the placement. There is one long established service user in the home with challenging behaviour who was admitted without an assessment. This has now been addressed and a one to one support in place. Holland House DS0000013676.V253741.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, 9, and 10 Individual care plans outline assessed and personal needs. Risk assessments are in place for all identified risks, to support service users with their daily living skills. Information relating to service users is handled appropriately. EVIDENCE: Individual care plans are in place. Three of these were sampled and contained detailed information on all aspects of service users care. Two service users were aware of the content of their care plan. Risk assessments are in place to manage daily life and choice, particularly when service users are outside the home. Two service users told the inspector that they are supported by staff to make decisions on how they wish to receive care, for example when they wish to have a sleep in or if they prefer a morning or evening bath. They also stated that staff support them take part in meaningful activities. Holland House DS0000013676.V253741.R01.S.doc Version 5.0 Page 10 It was encouraging to note that all service users have now been supported to open individual bank accounts since the last inspection. These accounts do not contain all personal finances as a proportion of money is still held centrally, however it is a positive step forward. Holland House DS0000013676.V253741.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, 13, 14, 15, and 17, Activity programmes are varied and are designed to meet individual and collective needs of service users. Links with friends, family, and the local community are good. The catering arrangements are satisfactory. EVIDENCE: Opportunity for personal development is provided and service users are supported to attend a local day centre where classes are provided in drama, music and movement, handy craft, language skills, cookery, and keep fit. Activities are also provided in the home, which include board games, card games, knitting, films, and music. Two service users had been to Tunisia during the summer and were pleased to show their holiday photographs to the inspector. They stated how they enjoyed the experience of the flight, the hotel and the swimming. Two other service users had been to Bognor Regis on holiday and both also had a good time. Following the assessed needs some service users are more comfortable having days out rather than a week away. Family links are maintained and visitors and friends are welcome at any reasonable time. Holland House DS0000013676.V253741.R01.S.doc Version 5.0 Page 12 Community links are also maintained and three service users explained how they like to do the food shopping in the local super store. They also stated they go to the local pub and to eat out sometimes. One service user stated that she attends church weekly with a church friend. All the service users spoken to stated that they liked their activities. The catering arrangements in the home suit the service users needs and preference. The staff team plans the menus, with input from the service users. These were seen during the inspection and the food offered is varied and nutritious. The Trust Dietician also monitors the menus. The main meal is served in the evening. This is prepared and cooked by the care staff with input from the service users. Holland House DS0000013676.V253741.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, 9 and 20. Appropriate procedures are in place to ensure personal support is available and delivered in a respectful and dignified manner. However specialist equipment must be provided to enable this to be carried out. EVIDENCE: Personal care is provided as outlined in individual care plans in a sensitive and caring manner to most service users. The manager stated when care needs change this is reviewed and updated in care plans. Specialist mobility equipment must to be provided to enable personal care to be delivered. All service users are registered locally with a GP. There is access to a chiropodist, optician and dentist when required. Physiotherapy is also available on request. The home has a medication policy in place. All staff who administer medication are familiar with these policies and procedures. There are currently no service users in the home that self medicate. The medication recording charts were seen and are well maintained. The medication is supplied in blister packs from the local chemist. The Trust’s Pharmacist undertakes audits and training. Holland House DS0000013676.V253741.R01.S.doc Version 5.0 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): These standards were not assessed during this visit. Please see the previous inspection report dated 18th April 2005. EVIDENCE: Holland House DS0000013676.V253741.R01.S.doc Version 5.0 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, 25, 27, 28, 29, and 30. The home is well maintained and homely. The standard of cleanliness and hygiene is good. The bathing facilities provide privacy but do not meet the mobility needs of some service users. EVIDENCE: The home is appropriate for the service users lifestyle and is accessible to all necessary services and community facilities. Some service users invited the inspector to visit and view their rooms. These are well maintained and decorated to reflect individual choice and personalities. One service user stated that her key worker helps her to maintain her personal space. The large lounge is well maintained and provides a homely environment for the service users in the home. The dining room is bright and well furnished. The home has two bathrooms and four toilets. The bathing facilities are not adequate to meet the assessed mobility needs of the service users. The manager stated that there is an assisted bath on order and anticipates that this well be installed in January 2006. Holland House DS0000013676.V253741.R01.S.doc Version 5.0 Page 16 There is a hoist available in the home following an individual moving and handling assessment. The manager stated that this was on loan. The registered person must provide a hoist in this home in accordance with health and safety legislation to protect the service users and staff. The home is clean and orderly. The manager stated that the level of incontinence has increased, however there was no evidence of mal odour. Arrangements are in place for the collection of clinical waste. Holland House DS0000013676.V253741.R01.S.doc Version 5.0 Page 17 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): 31, 32, 34, and 36. A team of competent staff, with clear defined roles and responsibilities, supports Service users. EVIDENCE: The duty rota was seen and indicated a good mix of staff with the skills necessary to meet individual needs. The manager stated that there is a wellestablished core team of staff who are supported by regular bank and agency staff. One service user stated that she was happy with the staff team and that she “felt calm”. There was evidence of staff recruitment since the last inspection. All the staff spoken to stated that are all in possession of a job description and terms and conditions of employment. The homes recruitment policies and procedures were sampled and found that they protect the service users. Two staff employment files were examined and all the required documentation was in place. All staff have formal supervision during which training needs can be identified. All the permanent staff team have an NVQ level 2 qualification and several staff have been identified to follow this with NVQ level 3. All staff receive induction training, which takes place over a three-day period. Holland House DS0000013676.V253741.R01.S.doc Version 5.0 Page 18 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, and 42. The home is well managed and service users views are taken into account. The health and safety of service users is not promoted. EVIDENCE: The registered manager is a qualified nurse with an RNMH qualification. She has considerable experience in the provision of care to people with a learning disability. Two service users stated that they felt supported and “safe” with the staffing structure within the home Good leadership skills were observed throughout the visit with both staff and service users having the confidence to interact as a team. Regular staff and service user meetings take place and these are documented. Health and safety policies and procedures were sampled throughout the inspection. These generally promote safety in the home. However the manual handling procedures need to be observed and specialist equipment to be provided where identified. All staff have training in COSHH procedures, first aid, food hygiene, moving and handling, and fire safety. The accident records were seen and are well maintained. Holland House DS0000013676.V253741.R01.S.doc Version 5.0 Page 19 The fire safety records were sampled and alarms are checked weekly and recorded. There is a contract in place for the maintenance of fire fighting equipment. Following the last visit from the contractors the fire extinguisher at the front door was not recorded as having been checked. This must be replaced or checked as safe immediately. Holland House DS0000013676.V253741.R01.S.doc Version 5.0 Page 20 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 3 3 X X X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 X 2 3 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score 3 3 X 3 X 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Holland House Score 2 2 3 X Standard No 37 38 39 40 41 42 43 Score 3 3 X X X 2 X DS0000013676.V253741.R01.S.doc Version 5.0 Page 21 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 18 and 19 Regulation 12(1)(b) Requirement Timescale for action 14/12/05 2 27 and 29 3 42 The registered person shall make provision for the service users to receive the personal support as outlined in their care plan to include the instillation of an assisted bath. 23(2)(n) The home must ensure that specialist equipment is provided to meet the changing needs of the service users, to include an assisted bath and a hoist. 23(4)(c)(iv) The registered person shall ensure they all fire fighting equipment is maintained. 14/12/05 14/12/05 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 Good Practice Recommendations Standard 18,19,27,29,and It is recommended that an action plan be submitted 42. to The Commission for Social Care Inspection outlining how the above requirements will be met by the 14/12/2005. Holland House DS0000013676.V253741.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Holland House DS0000013676.V253741.R01.S.doc Version 5.0 Page 23 - 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!