Inspection on 25/01/06 for Hollie Hill Care Home

This inspection was carried out on 25th 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Hollie Hill Care Home 02/02/09

Hollie Hill Care Home 07/02/07

Hollie Hill Care Home 16/06/05

Hollie Hill Care Home 13/01/05

Hollie Hill Care Home 30/07/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Hollie Hill Care Home Durham Road Stanley Durham DH9 6QZ Lead Inspector Mrs Sue Lowther Unannounced Inspection 25th January 2006 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 Hollie Hill Care Home DS0000000718.V257566.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 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. Hollie Hill Care Home DS0000000718.V257566.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Hollie Hill Care Home Address Durham Road Stanley Durham DH9 6QZ 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) 01207 280948 01207 280946 Tamaris Healthcare (England) Limited (wholly owned subsidiary of Four Seasons) Mrs Janis Watson Care Home 62 Category(ies) of Dementia - over 65 years of age (32), Old age, registration, with number not falling within any other category (30), of places Terminally ill (6) Hollie Hill Care Home DS0000000718.V257566.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. People with dementia over the age of 65 years of age to be accommodated within the 32 bedded unit for older people with dementia. These beds are not registered for the provision of continuous nursing care. 16th June 2005 Date of last inspection Brief Description of the Service: Hollie Hill is a purpose built home that was opened in July 1996. Built to a good specification, all bedrooms are for single occupancy and have en suite toilet and hand washing facilities. The home is tastefully decorated throughout and residents are encouraged to bring in their own possessions, including small items of furniture, to make their rooms more homely. Each section of the home has its own dining facilities and separate lounge. Bathrooms, showers and additional toilets are located throughout the building and all are fitted with special aids. The home is registered for two groups of service user. 30 Older people with or without nursing care needs and 32 people over 65 years with dementia who do not need continuous nursing care. These two groups are accommodated in separate units. Hollie Hill aims to ensure that service users will receive the level of care that satisfies the individual physical, personal, social, spiritual and emotional needs of service users. Hollie Hill Care Home DS0000000718.V257566.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 6 hours, on the morning and afternoon of 25th January 2006. In line with current CSCI policy on ‘Proportionality’, the inspection focused upon a number of key standard outcomes for service users. The key standard outcomes not inspected on this occasion were assessed during the last inspection of the home. The registered manager was present throughout the inspection. The inspector looked around the building and a number of records were examined. 10 service users, 3 visitors, the manager and 6 members of staff were spoken to. What the service does well: What has improved since the last inspection? What they could do better: The development of care plans must continue to ensure that a plan is available to meet all of the assessed needs of each service user. Records of the food provided for service users must be kept in sufficient detail to enable any person inspecting the record to determine whether the diet is satisfactory, in relation to nutrition and otherwise, and of any special diets prepared for individual service users. The registered manager must complete an appropriate management course. Hollie Hill Care Home DS0000000718.V257566.R01.S.doc Version 5.0 Page 6 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. Hollie Hill Care Home DS0000000718.V257566.R01.S.doc Version 5.0 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 Hollie Hill Care Home DS0000000718.V257566.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2&3 Admissions to the home are well managed. Service users receive appropriate information about the home and their needs are assessed prior to admission. EVIDENCE: Service users have now been issued with terms and conditions documentation but not all have been signed to confirm that they understand the service that they are entitled to receive. All service users are assessed prior to coming into the home. In addition to care manager assessments the registered manager normally visits the service user in their current place of residence. She advised the inspector that she would sometimes take another person with her if she feels this is needed. If she is on holiday this would be done by one of the qualified nurses or care staff where appropriate. The file of one service user recently admitted to the home was found to contain comprehensive information and the family confirmed that they had looked around the home and had been supplied with all of the information they required to make a decision about whether or not their relative would like to live there. Hollie Hill Care Home DS0000000718.V257566.R01.S.doc Version 5.0 Page 9 The home does not provide intermediate care and therefore assessment of Standard 6 is not required. Hollie Hill Care Home DS0000000718.V257566.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7&8 Individual care plans are in place, but some require more comprehensive information to ensure that all care needs are fully met. EVIDENCE: Each service user has a care plan and six of these were examined during the course of this inspection. Although it is acknowledged that progress has been made to update and regularly review care plans, as highlighted in the previous inspection report, there are still areas that require further development to include more comprehensive information. A care plan must be available for each aspect of care where a need had been identified during the assessment and evaluation process. There was evidence to confirm that some service users and relatives have been involved in the care planning process, but this was not evident in all of the care plans seen. Risk assessments have been carried out for service users which include falls risk assessment, nutritional assessment, moving and handling, bedrails risk assessment and assessment which identifies whether a person is at risk of developing a pressure sore. Hollie Hill Care Home DS0000000718.V257566.R01.S.doc Version 5.0 Page 11 The files also contained evidence to demonstrate that the home ensures service users health care needs are met. There were details of contacts with healthcare professionals including district nurses, GP’s, chiropodists and speech and language therapists. Service users can retain their own GP if they have lived in the local area. For those service users who come from outside of the area, arrangements have been made with a local surgery. The service users spoken to confirmed that their health care needs are adequately met within the home and that they are happy with the arrangements made. Hollie Hill Care Home DS0000000718.V257566.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 Social needs are recognised and provided for. The home has open visiting arrangements. Service users’ rights are respected and choice is provided. Meals are of a good standard. EVIDENCE: An activities co-ordinator is employed. On the afternoon of the inspection the activities co-ordinator organised a game of bingo. Other events are also arranged. A number of people spoken to said how much they enjoy these events. Social stimulation is considered within care planning arrangements and records are kept of events organised. It is also acknowledged that care staff provide activities wherever possible. Staff were seen to interact with service users in a respectful and dignified manner during social interaction. Hollie Hill has open visiting arrangements. The inspector spoke to 3 visitors who provided positive feedback. One visitor said, “I’m welcomed here, they will give you a cup of tea and there are also facilities where you can make your own”. Service users were asked about the choices they were given. One person spoke about being asked if they preferred to be called by their first name or Hollie Hill Care Home DS0000000718.V257566.R01.S.doc Version 5.0 Page 13 more formally by their surname. Another person said, “I can get up and go to bed when I wish ”. Staff were seen to treat people with respect. For example, by knocking on the door before entering a bedroom. Food served was seen to be of a good standard. People spoken to gave positive feedback and confirmed that there is a choice available. Service users nutritional needs are considered and recorded in care plans. Specialist diets are provided where necessary. However, it was noted that records of menu choices and food served have not been kept. Kitchen staff should be reminded that records of the food provided for service users must be kept in sufficient detail to enable any person inspecting the record to determine whether the diet is satisfactory, in relation to nutrition and otherwise, and of any special diets prepared for individual service users. Hollie Hill Care Home DS0000000718.V257566.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 & 18 Complaints and adult protection systems in the home serve to safeguard service users. EVIDENCE: The home has detailed complaints and adult protection procedures. Copies of these were seen to be available for staff use. Staff interviewed voiced a commitment to the service users they work with and to upholding service users’ rights. Information about complaints, how and who to make them to, is made available to service users and their families through information displayed in the home and in the ‘Service Users Guide’. A record is kept of all complaints made by service users or representatives or relatives of service users or by persons working at the care home about the operation of the care home, and the action taken by the registered person in respect of any such complaint. Service users said that they could approach the manager or a member staff who will listen to their complaints and sort them out as quickly as possible. Service users’ and families’ views are obtained through regular contact and an ‘open door policy’. Residents / Family meetings are held, which provide an additional forum to discuss any concerns or potential difficulties. Company policy and procedure documents relating to adult protection provide information and guidance to staff. Staff training in this area is also provided. A Hollie Hill Care Home DS0000000718.V257566.R01.S.doc Version 5.0 Page 15 copy of ‘Durham & Darlington Adult Protection Committee’s Inter-Agency Adult Protection Policy & Procedures’ on abuse and the protection of vulnerable adults are available in the home. Hollie Hill Care Home DS0000000718.V257566.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 25 & 26 The home was clean, comfortable and well maintained providing service users with a safe and pleasant environment EVIDENCE: A number of bedrooms and communal areas were viewed throughout the home. A good standard of maintenance is in place and the home was found to be clean and tidy. Service users spoken to said they liked being able to bring into the home small items of furniture along with photographs to make their own room more pleasant and homely. The communal areas of the home were clean and service users confirmed that their bedrooms were also cleaned to a good standard. A programme of redecoration was ongoing at the time of the inspection. Those areas completed were found to be bright and cheerful and were in a style liked by people living there. Hollie Hill Care Home DS0000000718.V257566.R01.S.doc Version 5.0 Page 17 The manager said that she had monitored that temperatures of the lounges as recommended in the previous inspection report and that a fan was available where required. Hollie Hill Care Home DS0000000718.V257566.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 The home has a settled, well-trained and well-led staff team. EVIDENCE: Hollie Hill has a settled staff team. Many of the staff spoken to have worked at home for a number of years and they know the service users well. Excluding ancillary staff, current staffing levels for the older persons part of the home are: a qualified nurse on duty throughout the day and night; plus, between 8am – 2pm 4 care assistants, between 2pm – 8pm 3 care assistants, and between 8pm – 8am 2 care assistants. The part of the home, which caters for older persons with dementia, is staffed with 1 senior care assistant and 4 care assistants from 8am - 8pm and with 1 senior carer and 2 carers from 8pm – 8am. From discussions with management and staff, and from an examination of duty rosters, sufficient staff are generally employed and rostered to work within the home. Although these staffing levels should be kept under review, they are considered adequate to meet the needs of the people currently accommodated. Recruitment procedures within the home, and through the parent company are safe. The files of two staff who had been recently recruited were examined. These confirmed that prior to employment, CRB (Criminal Records Bureau) disclosure checks are carried out. Applicants for employment complete an application form and 2 references are obtained. A reference from the last employer is requested, plus another; any gaps in employment are explored at interview. Hollie Hill Care Home DS0000000718.V257566.R01.S.doc Version 5.0 Page 19 Each member of staff receives a contract of employment and a job description and induction training is provided. Core training such as in First Aid and Moving and Handling is arranged, along with other courses such as continence and catheter care. Four Seasons Health Care have a training department who are now co-ordinating staff training in NVQ Level 2. Hollie Hill Care Home DS0000000718.V257566.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32 & 35 Service users can be confident that the home is well managed. Systems and safeguards are in place to ensure the health, safety and welfare of service users and staff is protected. EVIDENCE: The registered manager is a registered general nurse. She advised the inspector that the management course she is currently undertaking is due to be completed shortly. Service users’ views are obtained through daily contact and an ‘open door policy’. Similarly, the views of family and significant others are also obtained. Staff meetings and residents meetings’ are held as additional forums to discuss any concerns or potential difficulties. There are a number of audits that contribute to quality assurance systems operating in the home to ensure that the home runs smoothly. These include Hollie Hill Care Home DS0000000718.V257566.R01.S.doc Version 5.0 Page 21 audits of administration, human resources, housekeeping, resident care medication and kitchen and laundry services. The administrator is responsible for the record keeping with regard to service user finances. She was able to identify the amount that each resident had in his or her account. Hollie Hill Care Home DS0000000718.V257566.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 X 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 X 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 3 18 3 3 X X X X X 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 X X 3 X X X Hollie Hill Care Home DS0000000718.V257566.R01.S.doc Version 5.0 Page 23 Are there any outstanding requirements from the last inspection? YES 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 14, 15, 17 & Sch2 17(2) & Sch4(11) Requirement A care plan must be available for all of the needs identified in the assessment and evaluation process. Records of the food provided for service users must be kept in sufficient detail to enable any person inspecting the record to determine whether the diet is satisfactory, in relation to nutrition and otherwise, and of any special diets prepared for individual service users. The manager must complete a management-training course at NVQ level 4 or equivalent. Timescale for action 31/03/06 2 OP15 31/03/06 3 OP31 9 30/09/07 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 OP18 Good Practice Recommendations A copy of Durham & Darlington Adult Protection Committee’s Inter-Agency Adult Protection Policy & DS0000000718.V257566.R01.S.doc Version 5.0 Page 24 Hollie Hill Care Home Procedures on abuse and the protection of vulnerable adults should be obtained and be available in the home. The homes own policies and procedures in this area should be reviewed to reflect any local protocols and contact information. Hollie Hill Care Home DS0000000718.V257566.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 Hollie Hill Care Home DS0000000718.V257566.R01.S.doc Version 5.0 Page 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!