Random inspection report
Care homes for older people
Name: Address: Hollies, The 7 Mornington Road Southport Merseyside PR9 0TS two star good service The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Patricia Thomas Date: 0 8 0 6 2 0 0 9 Information about the care home
Name of care home: Address: Hollies, The 7 Mornington Road Southport Merseyside PR9 0TS 01704541506 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr John Thomson Eslick care home 24 Number of places (if applicable): Under 65 Over 65 24 old age, not falling within any other category Conditions of registration: 0 The registered person may provide the following category/ies of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 24 Date of last inspection Brief description of the care home The Hollies is a care home situated in Southport, close to shops and transport links to Liverpool. The home is owned by Mr Eslick and managed by Ms Helen Eslick and accommodates up to twentyfour elderly people. There is off street parking is at the front of the building and a secluded garden at the back. Accommodation is provided on three floors, which can be reached by a passenger lift. Disabled access is provided at the rear entrance via the patio doors. The Hollies has two lounges and a dining room, which are comfortably furnished. The bathrooms are fitted with aids to assist those
Care Homes for Older People Page 2 of 10 Brief description of the care home who are physically frail, and there is a call system for residents to summon assistance if necessary. To the side of the premises is the annexe or cottage, where visitors from out of the area may stay overnight if they wish. The annexe is not registered with the Commission. Care Homes for Older People Page 3 of 10 What we found:
Two inspectors from the commission carried out a short visit to The Hollies on 8 May 2009. We went to check if regulations were being met following some concerns raised by a visitor to the home. Previously, we had passed these concerns on to the manager who investigated them under the homes complaints procedure. We think the complaint had been taken seriously by the manager and she had sent a written response to the complainant within reasonable time limits. The manager told us it was not possible to uphold or disprove some of the concerns as some staff have left the home since the alleged occurrences and could not be interviewed. Also, in some instances the dates of alleged incidents were not alway available so it was not easy to establish which staff had been on duty. During this visit, we looked in general at outcomes for people who live in the Hollies, by speaking with them and reading records to see how their care and support is arranged. We spoke with staff and looked at training records to find out how about their knowledge and skills. We looked at aspects of the lifestyle in the Hollies, such as freedom of choice, independence, mealtimes and activities. What the care home does well:
We looked at the procedure used by staff at The Hollies to ensure that only people whose needs can be met by the service are accepted into the home. We found that there is a good system to introduce people to The Hollies with information given to them and needs assessments done, so they know that their needs can be met if they decide to move in. We looked at a sample of medication and found that the records are well maintained. This includes records relating to controlled medication as well as medication received into the home, given to people and returned to the pharmacy. These records help to establish a clear audit trail and prevent or deal with any issues which may arise. A church service is held in the home every month to support the needs of those who wish to follow their chosen faith. Staff said that arrangements for visiting ministers are made to meet the needs of people in residence at any time. People who live in The Hollies are offered a choice of meals and special diets are catered for. Five people we spoke with during our visit said the food is very good and that drinks are served regularly. One person told us she has all she needs and spends her time as she likes. Another person said she thinks the home is friendly and relaxed. None of those we spoke with expressed any concerns about staff conduct, describing them as being kind and helpful. We spoke with four members of staff on duty and looked at training records. This gave us evidence that staff are supported by management to take up training. The courses they have done range from health and safety, fire safety and food hygiene to specialist training for dementia and medication. In discussion, staff showed awareness of the needs and preferences of people who live at The Hollies. Staff were able to explain how they support people to stay as independent as possible and the different ways people like to spend their time. They were also able to explain how they support people with their health and personal care and make themselves understood to people who have communication difficulties. Staff knowledge along with regular training updates provided in The Hollies means that staff are up to date with current best practice on how to support people safely and well.
Care Homes for Older People Page 4 of 10 We asked the manager about how staff break times are arranged. She said the rule is that a member of care staff should be left on the premises if a colleague takes a smoking break in the garden. This means that people living in the home will not be at risk through lack of supervision in the lounges and a member of staff should always be available to help them if needed. What they could do better:
We looked at the records for two people who have recently come to live in The Hollies. We found that good evidence that information about peoples health and personal care needs had been obtained before they moved in through assessments carried out by social services and staff from the home. This meant that there was up to date information to guide staff when writing their individual care plans and completing risk assessments to keep them safe. More attention is needed to find out about peoples social, cultural and religious needs before they move in as these sections of the assessment forms had been left blank. This could mean they are not getting the full range of support they need and prefer. Individual care plans are in place for all people living in the Hollies. Records show that these are reviewed monthly and discontinued if no longer needed. However, the care plans we looked at were brief and did not fully guide staff about the support the person requires. For example, one care plan states two members of staff to assist the person with washing and dressing. However it does not give any guidance on how this is to be done or how to support the person to wash their hair or use the bath. A member of staff we spoke with was able to clearly explain this and it was evident that staff are aware of how to support people. The brief information we saw in care plans may not be sufficient to ensure that unfamiliar staff can support people safely and well. Similarly we read notes that stated one person had a sore on their heel. Staff had acted appropriately by seeking advice from the district nurse. No short-term care plan had been written to advise staff on the care the person needed with this. In reading the records, we were unable to establish the progress of this wound until we spoke with staff who told us it had healed. A lack of recording issues like these, which are short term problems, could lead to health issues not being dealt with as effectively as they should be. We found that improvements need to be made regarding storage of medication. A medication storage cabinet has been purchased to hold all controlled drugs but this has not yet been fitted and could mean that these drugs are not being stored as safely as they should be. We saw that medication requiring refrigeration is stored in a kitchen fridge drawer. A lockable fridge for this would ensure that this medication is stored as safely as possible. Also, the homes locked medication room felt warm on the day of the visit. There is a thermometer in this room, however, without any records of the room temperatures it is not possible to establish whether medication is being stored in line with safe temperature instructions. We think that more accurate records should be kept about the meals served in the home. We saw there were good food stocks and there is a three-weekly menu in place which shows a variety of food is offered. However, staff do not keep a record of meals served and it may be difficult to accurately audit whether people are being offered a healthy diet that meets their needs and choices. On the day of our visit, the menu recorded one
Care Homes for Older People Page 5 of 10 vegetable to be served with the lunch time meal. In fact, people were served two vegetables. Similarly the records do not show the alternatives the home offers, including those for people who do not eat meat. In looking at how bedrails safety is managed in The Hollies we found that there were no records of safety monitoring. It is required that risk assessments be carried out for bedrails, and these should be regularly reviewed to keep people safe and protected from the risk of injury from the bedrails and ensure these are the best option for them. We looked at how complaints are managed, and found that there is a complaints procedure given to people who live in The Hollies so they know about their right to make complaints. A record of complaints is kept in the home, the last we read being made in November 2008. The file did not have details of the most recent complaint, and we have recommended that in future, the records be kept up to date and available for inspectors. The manager explained that the investigation had been done and a reply had been sent to the complainant but the records were held elsewhere. The manager apologised for this oversight and sent us the information about her investigation the day after our visit. 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 2. Care Homes for Older People Page 6 of 10 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, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 10 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, 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 1 9 13 Arrangements must be made 17/07/2009 for adequate storage for controlled drugs and medications which need to be stored in the fridge. This means that drugs will be stored safely and in line with the manufacturers instructions. 2 38 13 A risk assessment must be 17/07/2009 carried out for use of bedrails, be regularly reviewed and include information about the bedrail being used and how it complies with legislation. This will help to ensure that bedrails are the safest option and will be safe for people to use. Care Homes for Older People Page 8 of 10 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 2 A full assessment of peoples needs (including their social, cultural and religious needs and wishes) should be carried out before they move in to ensure these needs can be met while they are living in The Hollies. The information in care plans should be expanded to ensure it provides enough information to guide staff in supporting people with short term care issues. This will mean that staff have the information they need to keep people safe and well. That the temperature of the medication room is monitored to ensure that medication is being stored in line with safety instructions. That a record of meals served, including alternatives and special diets is kept in the home. This will provide a clear audit trail of the support people are receiving with their nutrition. 2 7 3 9 4 15 5 16 That the complaints records held in the home, including provider investigations, outcomes and feedback to complainants be kept up to date. This will give evidence that the home takes complaints seriously and takes action. Care Homes for Older People Page 9 of 10 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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 © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 10 of 10 - 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!
