Inspection on 02/06/05 for Hollins Park Nursing Home

This inspection was carried out on 2nd June 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

Hollins Park Nursing Home 17/07/07

Hollins Park Nursing Home 03/10/06

Hollins Park Nursing Home 09/11/05

Hollins Park Nursing Home 15/12/04

Hollins Park Nursing Home 11/05/04

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

CARE HOMES FOR OLDER PEOPLE Hollins Park Nursing Home Victoria Road Macclesfield Cheshire SK10 3JA Lead Inspector Denis Coffey Unannounced 2 June 2005 09:00 nd 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 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. Hollins Park Nursing Home F51 F01 S18801 Hollins Park V224420 020605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Hollins Park Nursing Home Address Victoria Road Macclesfield Cheshire SK10 3JA 01625 503028 01625 503031 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Community Health Services Ltd Mrs Tamara Simmons Care Home 49 Category(ies) of DE(E) Dementia over 65 (49) registration, with number DE Dementia (5) of places PD Physical Disability (1) Hollins Park Nursing Home F51 F01 S18801 Hollins Park V224420 020605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 This home is registered for a maximum of 49 service users to include: * up to 49 service users in the category of DE(E) (Dementia over the age of 65 years) * up to 5 service users in the category of DE (Dementia under the age of 65 years) * 1 named service user in the category of PD (Physical disability). 2 The registered provider must at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection 15th December 2004 Brief Description of the Service: Hollins Park provides nursing care for 49 residents suffering from dementia. Five of the 49 places can be used to accommodate residents under the age of 65 years. The home is a detached two-storey purpose built property situated in its own grounds near to Macclesfield District General Hospital. It is approximately one mile from Macclesfield town centre. The accommodation comprises of four wings on two floors with 33 single and 8 double bedrooms. Each wing has a lounge, dining room and smaller lounge. There is passenger lift access to the first floor. Hollins Park Nursing Home F51 F01 S18801 Hollins Park V224420 020605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 5.5 hours and included a tour of the home as well as inspection of care records. The inspector spoke with six of the forty-three service users, five members of staff and three sets of visitors. What the service does well: 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. Hollins Park Nursing Home F51 F01 S18801 Hollins Park V224420 020605 Stage 4.doc Version 1.30 Page 6 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 Standards Statutory Requirements Identified During the Inspection Hollins Park Nursing Home F51 F01 S18801 Hollins Park V224420 020605 Stage 4.doc Version 1.30 Page 7 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 standard(s) 3 Full assessments of needs are carried out before residents move in so they know that their needs can be met at the home. EVIDENCE: The records of four residents who had recently moved into the home were examined. All contained assessments that had been carried out by a trained nurse employed at the home before the resident had moved in. The assessments are based on the activities of daily living, and any problems/needs identified were addressed in the residents care records. Hollins Park does not offer intermediate care so Standard 6, identified above, does not apply. Hollins Park Nursing Home F51 F01 S18801 Hollins Park V224420 020605 Stage 4.doc Version 1.30 Page 8 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 standard(s) 7, 8, 9 & 10 Although there are care records for the residents, they need improving to ensure that all their needs are met effectively. Staff make sure that residents’ dignity and privacy are respected at all times. Although the medicines generally are managed well, improvements are needed to be made to the records so that accurate stock levels can be accounted for. EVIDENCE: The care records of four residents were examined at this inspection. Care plans were in place to identify how their needs/problems were being met, and evidence was seen of these being evaluated on a regular basis. However, the moving and handling assessment for one resident identified her as being able to walk with the aid of a walking frame, but her care plan for mobility stated that she could no longer weight bear and that a mobile hoist was required for all movement. This service user had an assessment of her skin that showed her as a high risk of developing a pressure sore, but a care plan had not been documented outlining how this problem was to be managed. All of the residents are registered with a general practitioner and records were kept of when residents were visited by their doctors. Records were also seen of other healthcare professionals being involved in the care of the residents. Hollins Park Nursing Home F51 F01 S18801 Hollins Park V224420 020605 Stage 4.doc Version 1.30 Page 9 Medicines were stored in a locked trolley in a medicine storage room, the door to which was locked. There were numerous gaps in the residents’ medication administration record (MAR) sheets with no explanation as to why the resident had not received their medicines. One resident had been prescribed a strong pain relief medicine, the use of which had been discontinued. The records showed that when last used, there were a total of 104 tablets of this medicine left in stock. A subsequent record also showed the same number, but a later record stated that there were now 102 tablets in stock. A reason as to how this discrepancy had occurred could not be given. One resident was receiving a controlled drug for pain relief and the stocks of this medicine were found to be correct. The home has a ‘homely remedies’ policy whereby trained nurses can administer medicines over a twenty-four hour period without a prescription. These medicines were identified, and the residents’ general practitioner had signed agreement for these to be given. Staff were heard to speak with residents appropriately, and were seen to maintain the dignity and privacy of the service users when attending to their personal needs. Service users and visitors spoken with said that they feel supported by the staff, and said they are happy with the care they receive. Hollins Park Nursing Home F51 F01 S18801 Hollins Park V224420 020605 Stage 4.doc Version 1.30 Page 10 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 standard(s) 12, 13, & 15 There is no regular activities programme for residents to keep them active and stimulated. The food is a good standard and enjoyed by the residents so they receive a varied and nutritious diet. EVIDENCE: A part time activities organiser had been employed at the home, but because of staffing vacancies this member of staff is now employed as a full time care assistant. Staff said that activities are not provided regularly, but on an adhoc basis when time permits. Three sets of visitors were spoken with all of who were complimentary about the standard of care provided. They also said that they were made to feel welcome at visiting times. The menus appeared varied and nutritious in content. The home operates a ‘chill cook’ process whereby food delivered to the home arrives in a chilled container, and when needed is cooked on the premises. Lunch is the main meal of the day, and on the day of inspection this was a choice between sausages and onions or turkey casserole, both of which were served with potatoes, carrots and peas. A dessert of lemon sponge or bananas and custard followed this. One of the residents prefers finger food, and items preferred by this resident were purchased at a local supermarket. Hollins Park Nursing Home F51 F01 S18801 Hollins Park V224420 020605 Stage 4.doc Version 1.30 Page 11 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 standard(s) 16 & 18 There is information available to guide residents and relatives on how to make a complaint and who to make it to. There are procedures and guidance available for staff to ensure that residents are protected from abuse, harm and poor practice. EVIDENCE: The home has a complaints procedure that residents and relatives know how to use. There have been no recorded complaints received at the home since the last inspection. As well as having its own policy on adult protection the home has a copy of the Department of Health’s document ‘No Secrets’ that gives additional information about adult abuse. The home has a whistle blowing policy that advises staff on how to make their concerns known if they witness or suspect poor practice occurring. Two members of staff spoken with said that they were unaware of the ‘No Secrets’ document’ and that they had not read the home’s whistle blowing policy. However, both demonstrated a positive and accurate response on their role in protecting residents from abuse. Records were seen of nine members of staff receiving training this year on the protection of vulnerable adults. Hollins Park Nursing Home F51 F01 S18801 Hollins Park V224420 020605 Stage 4.doc Version 1.30 Page 12 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 standard(s) 19, 21 & 26 The general standards of décor, furnishings and hygiene are good, providing residents with safe, comfortable and homely surroundings. EVIDENCE: Bedrooms were carpeted and comfortably furnished, many with items residents had brought into the home with them. New carpets have been laid in the main lounges, and laminate flooring in the dining rooms since the last inspection. Two of the four satellite kitchens on the units have been upgraded recently, and plans are in place for this work to be carried out in the two remaining kitchens. Whilst the general standard of décor had been well maintained around the home there were a few areas that require attention. These were damaged walls in two bedrooms and one of the dining rooms, as identified to the home’s deputy manager at the time of the inspection. The television in one of the lounges was broken. The deputy manager was not aware of this problem but said she would attend to it. Hollins Park Nursing Home F51 F01 S18801 Hollins Park V224420 020605 Stage 4.doc Version 1.30 Page 13 There are adequate toilet and bathing facilities at the home close to the lounge and bedroom areas. There is a shower room on the first floor that contains a toilet and hand washing facilities that did not have a curtain around the shower. All parts of the home were visited at this inspection and found to be clean, tidy and free from unpleasant smells apart from two bedrooms on the first floor, both of which had a noticeable smell in them. Records were seen of the temperatures of the refrigerators and freezers being recorded twice a day, and also of the temperatures of hot food when it came out of the oven, and at the point of it being served to the residents. This was done to ensure that the residents’ food was being kept and served at safe temperatures. Hollins Park Nursing Home F51 F01 S18801 Hollins Park V224420 020605 Stage 4.doc Version 1.30 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 & 30 There are enough staff on duty to meet the needs of the residents at all times. Recruitment procedures include thorough checks of new staff, ensuring that the residents were protected from possible harm or poor practice. EVIDENCE: The staffing rotas showed that sufficient staff to meet the residents’ needs were on duty at all times. On the day of inspection one of the trained nurses rostered for duty had not turned up due to sickness. Another member of the trained staff who was off duty came in for a short period, following which the deputy manager (who was working in a supernumery capacity) took this nurse’s place. The deputy manager said that there is currently 125 hours care assistant vacancies at the home and that prospective staff had been interviewed for these hours, but could not yet start work, as references had still not been received. The personnel files seen of two new staff employed at the home contained completed application forms, two satisfactory written references, job descriptions, statements of terms and conditions of employment, and health assessments. Both had a satisfactory record of a protection of vulnerable adults disclosure. One had a satisfactory Criminal Records Bureau (CRB) disclosure. The deputy manager was aware that the new member of staff who had as yet no had a satisfactory CRB had to be supervised at all times when delivering personal care to the residents. Hollins Park Nursing Home F51 F01 S18801 Hollins Park V224420 020605 Stage 4.doc Version 1.30 Page 15 The training records for 2005 showed that: • • • 18 staff had received introductory training in Health and Safety 17 staff had undergone safe moving and handling training 2 staff have received updated training in first aid The company that runs the home has developed a new induction training pack for staff, and the deputy manager and one of the trained nurses have attended a training day on how to implement this. The deputy manager and two of the trained nurses attended a training course in March entitled ‘train the trainers’. All of the trained nurses on day duty have attended training on the management of artificial feeding methods. The deputy manager said that this training was also being offered to the trained nurses working night duty. Hollins Park Nursing Home F51 F01 S18801 Hollins Park V224420 020605 Stage 4.doc Version 1.30 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 The home is well managed. The health, safety and welfare of residents and staff is generally well managed but there are areas where this could be improved upon. EVIDENCE: Records were seen of the fire alarm system being tested weekly, and of twenty-eight members of staff receiving fire safety training this year. An engineer’s report was seen regarding problems encountered with the emergency lighting at the home. This report, dated December 2004, identified that some of the lights were not working and that some of the lights were dim. The deputy manager said that replacements for these lights have been ordered but could not say when these would be fitted. It was also identified that the call alarm system for the residents was not fully operational. Hollins Park Nursing Home F51 F01 S18801 Hollins Park V224420 020605 Stage 4.doc Version 1.30 Page 17 A member of Cheshire fire Brigade visited the home in February this year and made a number of requirements as a result of this visit. The home manager said that these had been attended to. However, one requirement was that a weekly visual inspection be made of the fire extinguishers at the home. There was no record available to confirm that this has been done. A review of accidents sustained by residents showed that since March 2005 to date there was a total of forty-five accidents, the majority of which were attributed to falls/trips. The home manager conducts a monthly review of accidents. Records were seen of individual falls risk assessments being carried out on residents, but there was no risk assessment on the general environment to identify potential problems and how these could be minimised. Thermostatic valves are fitted to the baths to regulate the temperature of the hot water supplied to them, and when tested the hot water temperatures were found to be within acceptable limits. Hollins Park Nursing Home F51 F01 S18801 Hollins Park V224420 020605 Stage 4.doc Version 1.30 Page 18 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 x 2 x x x x 2 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x x x x 2 Hollins Park Nursing Home F51 F01 S18801 Hollins Park V224420 020605 Stage 4.doc Version 1.30 Page 19 No 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 7 Regulation 15 Requirement Suitable plans of care must be in place addressing all of the identified needs of the residents in relation to their health and welfare. Arrangements must be made for the accurate recording of all medicines administered at the home. This requirement remains unmet from the last inspection. Arrangements must be made for the provision of suitable recreational and leisure activities for the residents. Arrangements must be made for the redecoration of those areas identified as requiring this. Arrangements must be made for the damaged television set to be repaired or replaced. Arrangements must be made to ensure that all areas of the home are kept free from unpleasant smells. A curtain must be provided around the shower in the first floor shower room for residents privacy. Arrangements must be made to replace all of the faulty emergency lights at the home. F51 F01 S18801 Hollins Park V224420 020605 Stage 4.doc Timescale for action 20/06/05 2. 9 13 13/06/05 3. 12 16 20/06/05 4. 5. 6. 19 19 21 23 16 16 30/06/05 30/06/05 20/06/05 7. 21 12 30/06/05 8. 38 23 20/06/05 Hollins Park Nursing Home Version 1.30 Page 20 9. 10. 38 38 23 23 Arrangements must be made for the call alarm system to be repaired. Arrangements must be made for a visual inspection of the fire extinguishers to be made on a weekly basis. 30/06/05 20/06/05 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. 2. Refer to Standard 18 38 Good Practice Recommendations All staff employed at the home should be encouraged to read the document No Secrets, and the homes whistle blowing policy. A falls/trips risk assessment of the premises should be carried out and recorded. Hollins Park Nursing Home F51 F01 S18801 Hollins Park V224420 020605 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Unit D, off Rudheath Way Gadbrook Park Northwich Cheshire CW9 7LT 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 Hollins Park Nursing Home F51 F01 S18801 Hollins Park V224420 020605 Stage 4.doc Version 1.30 Page 22 - 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. 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