Inspection on 30/05/06 for Hollin Knowle

This inspection was carried out on 30th May 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Hollin Knowle 29/04/08

Hollin Knowle 06/11/07

Hollin Knowle 05/06/07

Hollin Knowle 16/06/05

Hollin Knowle 23/03/05

Hollin Knowle 05/05/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Hollin Knowle 78 Fairfield Road Buxton Derbyshire SK17 7DR Lead Inspector Rose Veale Unannounced Inspection 30th May 2006 10:00 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 Hollin Knowle DS0000020019.V297553.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. Hollin Knowle DS0000020019.V297553.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hollin Knowle Address 78 Fairfield Road Buxton Derbyshire SK17 7DR 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) (01298) 22534 Mr Mohammed Shamsul Islam Mrs Shajeda Islam Mrs Shajeda Islam Care Home 19 Category(ies) of Old age, not falling within any other category registration, with number (19) of places Hollin Knowle DS0000020019.V297553.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th October 2005 Brief Description of the Service: Hollin Knowle is a care home registered to provide personal care and accommodation for up to 19 residents aged 65 years or over. The home is situated on the outskirts of Buxton where a variety of amenities are available. Local shops are near to the home. Accommodation is provided over 3 floors which are accessed via a passenger lift. There are 2 lounge areas and a dining room. Additional communal space consists of a sitting area on the first floor adjacent to bedrooms. Gardens and car parking space are also provided. The minimum fees per week are at the Derbyshire County Council funding level, currently £334 per week, (information provided by the provider/manager on 30/05/06). Hollin Knowle DS0000020019.V297553.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over 5½ hours. There were 17 residents accommodated in the home on the day of the inspection. Residents and staff were spoken with during the inspection. Some residents were unable to contribute directly to the inspection process because of communication difficulties, but they were observed during the visit to see how well their needs were met by staff. Records were examined including care plans, staff records, policies, maintenance records, and health and safety records. The manager was available and helpful throughout the inspection. What the service does well: What has improved since the last inspection? What they could do better: Some requirements have been outstanding for the previous two inspections and the providers now need to demonstrate a serious commitment to meeting the requirements and further improving standards at the home. Further work is needed to ensure care plans include all the assessed needs of residents, are produced in consultation with residents or their representatives, and are regularly reviewed and updated. Hollin Knowle DS0000020019.V297553.R01.S.doc Version 5.2 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. Hollin Knowle DS0000020019.V297553.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 Hollin Knowle DS0000020019.V297553.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents’ needs appeared to be assessed and met in a satisfactory way. Residents did not have written assurance that the home was able to meet their needs. EVIDENCE: The care records of 2 residents were examined. Both records included the assessment by the care manager prior to the resident’s admission, and the hospital assessment for 1 resident. This was a requirement at the last inspection and therefore had been met. Both records included an assessment of the resident’s needs carried out by the manager of the home. There was no written confirmation provided to residents that their needs could be met by the home. This was a requirement at the last inspection and the requirement has been carried forward in this report. Each record had a care plan produced from the assessment information. The care plans did not include all the assessed needs of residents or sufficient detail of the action needed by staff to meet residents’ needs. Residents spoken with said that their needs were generally Hollin Knowle DS0000020019.V297553.R01.S.doc Version 5.2 Page 9 being met by the home. Staff spoken with said that the home was able to meet the needs of all the residents currently accommodated. The records included review meeting notes which showed that the home was meeting the residents’ needs. Standard 6 did not apply to this service. Hollin Knowle DS0000020019.V297553.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents needs appeared generally to be met, with evidence of respecting dignity and privacy, and good liaison with other health care professionals. Care plans needed more detail to ensure all the needs of residents were fully met. EVIDENCE: The care plans of 2 residents were examined. The care plans included detailed risk assessment with clear information for staff on the action needed to protect residents and reduce the risk of harm. Details of the residents’ social and family history were included in the care plans, plus details of their preferences regarding social activities and spiritual needs. One care plan had been signed by the resident to indicate their involvement. Residents spoken with said they had not been involved in planning their care. Neither of the care plans included all the assessed needs of the resident. For example, both residents had been assessed as being at high risk of developing pressure sores but there was no care plan to indicate what action should be taken by staff to prevent pressure sores. Both care plans had been reviewed, one recently and the Hollin Knowle DS0000020019.V297553.R01.S.doc Version 5.2 Page 11 other over a year ago. The reviews took the form of a general review of the residents’ physical and mental health and personal care needs, rather than a specific review of the care plan. There were records of the input of the resident’s GP, District Nurse, dentist, chiropodist and optician. There was evidence that health problems were promptly referred to the appropriate person. For example, the care staff noted in the daily records that a resident had a sore heel. This was referred promptly to the District Nurse who saw the resident and advised treatment. Residents spoken with said that the doctor was asked to visit as necessary. Residents said they were seen regularly by a chiropodist. Residents spoken with said the staff were “kind”, “patient”, and that “nothing is too much trouble”. Staff were observed to be respectful in their approach to residents, for example knocking on bedroom doors before entering, ensuring the residents’ understanding before starting moving and handling procedures, and reassuring a resident who was agitated. A new medication system had been introduced since the last inspection and this was reported to be working well. The pharmacist visited every 3 months to check on the stocks held and any problems. The pharmacist also carried out regular refresher training for staff responsible for giving out medication. Hollin Knowle DS0000020019.V297553.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 at least once during a 12 month period. 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 the service. Generally, residents were offered a suitable range of activities to meet their social needs. The meals provided were of a good standard and mostly met the expectations and needs of residents. EVIDENCE: The care records seen included details of the resident’s social history, previous interests / hobbies and their preferences regarding activities. Records were kept of activities offered to residents and these included walks out, a regular church service held at the home, games, exercises to music, and helping in the garden. The hairdresser was visiting on the day of the inspection and residents clearly enjoyed the social aspect of having their hair done. Residents were observed to help with setting the tables for lunch. A group of residents were observed enjoying a game of dominoes with a member of staff. Residents spoken with said they were pleased with the activities offered, particularly the music and movement and the visiting organist. Two residents said they would like to have trips out of the home. Residents said they were able to go to bed and get up when they wanted to. Residents said their visitors were made welcome and could visit at any reasonable time. The manager said that staffing levels had been increased since the last inspection. There were Hollin Knowle DS0000020019.V297553.R01.S.doc Version 5.2 Page 13 four staff on duty on the morning of the inspection which allowed time for activities with residents. Residents spoken with said the meals at the home were of a good standard with choices offered if they did not want what was on the menu. The menus seen appeared varied and well balanced. One resident said they were disappointed with the lack of variety for their particular dietary needs. Hollin Knowle DS0000020019.V297553.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Residents were generally protected from abuse. Residents and their representatives did not have access to an effective, robust complaints procedure. EVIDENCE: The home’s complaints procedure did not include timescales for dealing with complaints. The care records seen included satisfaction questionnaires for residents’ relatives / representatives and it was noted on these that they had not received a copy of the complaints procedure. Residents spoken with said they had “no complaints” and that they would be able to go to the staff or the manager with any concerns or problems. One resident said they were able to voice concerns to the manager but felt that action was not always taken as needed. The manager said she had undertaken training in the protection of vulnerable adults and was awaiting an assessment before she could deliver in-house training to staff. Some staff had received in-house training. Staff spoken with knew the correct procedures to follow if they suspected abuse. The home’s policy on the protection of vulnerable adults included reference to the Derbyshire County Council multi-agency guidelines. There was a whistleblowing policy. Hollin Knowle DS0000020019.V297553.R01.S.doc Version 5.2 Page 15 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 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Although the home was clean and comfortable, a number of ongoing environmental problems had not been addressed and so residents could not be confident of a safe and well maintained environment. EVIDENCE: A tour of the building was carried out, including most of the bedrooms. The home was clean, tidy and generally free from offensive odours. Bedrooms seen were pleasant and personalised with residents’ own possessions. Shared bedrooms seen all had privacy curtains. The lounges were comfortably furnished. Some items raised at previous inspections had been addressed, such as provision of new armchairs in the lounge, provision of a fax machine, and replacement of a cracked window. Other items and requirements had not been addressed, as follows: Hollin Knowle DS0000020019.V297553.R01.S.doc Version 5.2 Page 16 • • • • • bedrooms did not contain all of the required furniture and fittings, such as bedside lighting, a chest of drawers, lockable storage, comfortable seating and at least 2 double sockets. there was no means of internal communication for staff between the floors of the home potentially putting residents at risk when only 2 staff were on duty. mattresses and headboards were in need of review / replacement two bedrooms had window frames that were in need of repainting, repair or replacement commodes, bedding and towels were worn and in need of replacement It was a requirement at the previous inspection that the providers must supply an action plan detailing when and how these outstanding items would be addressed. This requirement had not been met and has been carried forward in this report. The manager said that an audit was being carried out of each room to see what was needed to meet the national minimum standards. Residents spoken with said they were pleased with their bedrooms. The laundry was suitably equipped. The floor in the laundry and food storage room had not been covered with an impermeable membrane as required in previous reports. The manager said this was in hand and would be done by the end of June 2006. The requirement has been carried forward in this report. Hollin Knowle DS0000020019.V297553.R01.S.doc Version 5.2 Page 17 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 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Residents were generally adequately supported by staff in sufficient numbers and with enough training to meet residents’ needs. EVIDENCE: The staff rota was seen and showed that generally there were 3 staff on morning shifts and 2 staff on afternoon shifts. Some days had additional staff to cover busy times and to provide for activities. The staffing levels had improved since the last inspection when there were 2 staff on duty on morning and afternoon shifts. Residents spoken with said that there were usually enough staff on duty to meet their needs, although one resident was not happy with the staffing levels and said this concern had been raised with the manager. Staff spoken with said the staffing levels were satisfactory for the current dependency levels of residents. As reported at previous inspections, there are residents who need 2 carers to look after them and therefore times when residents in the lounges would not be supervised. The rota did not record the hours worked by the manager. Staff records were examined and generally included all the required information. Staff training records showed that staff had undertaken the required training in first aid, moving and handling, basic food hygiene and fire safety. Staff spoken with confirmed that the training had been undertaken and that further training was planned for May and June 2006. The training had Hollin Knowle DS0000020019.V297553.R01.S.doc Version 5.2 Page 18 mostly been delivered by external training organisations. Of 14 care assistants, 7 had achieved NVQ Level 2 or 3 in care and the manager said that 2 more were to commence NVQ training. Staff said they would find it useful to have training in dementia awareness. There was an induction programme for new staff and induction records had been completed on one staff file seen. The induction programme did not appear to meet nationally recognised specifications. Hollin Knowle DS0000020019.V297553.R01.S.doc Version 5.2 Page 19 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, 33, 35 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Further work on health and safety and quality assurance was needed to ensure the home was effectively managed and run in the best interests of residents. EVIDENCE: The manager was experienced, having owned and managed the home for many years, and had commenced NVQ Level 4 in management. Residents spoken with said the manager was approachable and would listen to their concerns. One resident said that the manager did not always appear to act on concerns raised. Staff spoken with said the manager was approachable and they liked her ‘hands on’ style. There were records of staff supervision and appraisal, though not all staff had this regularly. Staff spoken with said that staff meetings took place approximately every six months. Hollin Knowle DS0000020019.V297553.R01.S.doc Version 5.2 Page 20 There was no formal quality assurance system in place in the home. This was a requirement at previous inspections and has been carried forward in this report. There were some quality assurance measures in place, such as satisfaction questionnaires for residents’ relatives or representatives, and a weekly environmental audit checklist. There were records of the personal money held by the home on behalf of residents. The records were up to date and had two signatures for each transaction. Health and safety records were examined, including the fire log book, accident book and maintenance records. The records were generally well kept and up to date. There were no records of fire drills at the home. There was no Landlords Gas Safety Certificate available for inspection and no system in place for the control of Legionella as required at the last inspection. Risk assessments were seen covering all areas of the home and of tasks carried out by staff. Hollin Knowle DS0000020019.V297553.R01.S.doc Version 5.2 Page 21 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 X 2 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 2 17 X 18 2 2 X X X X X X 2 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 2 Hollin Knowle DS0000020019.V297553.R01.S.doc Version 5.2 Page 22 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 OP4 Regulation 14 (1)(d) Requirement Timescale for action 30/06/06 2. OP7 15 (1) 3. OP19 23 4. OP27 18 Confirmation in writing must be provided to service users that, having regard to the assessment, the care home is suitable for the purpose of meeting their needs. Previous timescale 31.07.05 Care plans must include all the 30/09/06 assessed needs of residents and must be produced in consultation with residents or their representatives. All of the matters identified in 31/07/06 the environment section of this report must be addressed, and an action plan must be provided with timescales for completion by the date given. Previous timescale 30/03/05 A risk assessment for the home 31/08/06 must be completed which looks at staffing levels in relation to the safe supervision of service users when there are two staff on duty and when there is one person on duty and one person sleeping-in. It must take into account the layout of the building and the number of DS0000020019.V297553.R01.S.doc Version 5.2 Hollin Knowle Page 23 5. OP30 18(1)(c) 6. 7. 8. OP33 OP38 OP38 24 23(4)(c) (iii) 17(2) 13(4)(c) service users who need two staff to assist them with any tasks. A copy of this assessment must be sent to the CSCI office. From inspection report 05.05.04. Structured induction training which meets nationally recognised standards must be provided and recorded in staff training files. A formal quality assurance system must be put in place. From inspection report 05.05.04. A record must be kept of all fire drills in the home. A current Landlords Gas Safety Certificate must be sent to the CSCI office. Previous timescale 30/11/05 Systems must be put in place for the control of Legionella. Previous timescale 28/02/06 An impermeable membrane must be provided to the floor in the food storage room. From inspection report 05.05.04. 30/09/06 31/12/06 30/06/06 30/06/06 9. 10. OP38 OP38 13(4)(c) 16(2)(g) 30/09/06 31/07/06 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. 2. 3. 4. Refer to Standard OP27 OP30 OP38 OP38 Good Practice Recommendations The hours worked by the manager should be included on the staff rota. Staff should have training in the needs and care of people with dementia. Fire drills should be held at least every six months. An internal communications system / phone should be considered. Hollin Knowle DS0000020019.V297553.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Hollin Knowle DS0000020019.V297553.R01.S.doc Version 5.2 Page 25 - 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. 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