Inspection on 03/10/06 for Hollins Park Nursing Home

This inspection was carried out on 3rd October 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 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 09/11/05

Hollins Park Nursing Home 02/06/05

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 Key Unannounced Inspection 09:00 3rd October 2006 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 Hollins Park Nursing Home DS0000018801.V298960.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. Hollins Park Nursing Home DS0000018801.V298960.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hollins Park Nursing Home Address Victoria Road Macclesfield Cheshire SK10 3JA 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) 01625 503028 01625 503031 Community Health Services Limited Mrs Tamara Simmons Care Home 49 Category(ies) of Dementia (5), Dementia - over 65 years of age registration, with number (49), Physical disability (1) of places Hollins Park Nursing Home DS0000018801.V298960.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 49 service users to include: * * * 2. 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) The registered provider must at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection 9th November 2005 Date of last inspection Brief Description of the Service: Hollins Park provides nursing care for 49 residents suffering from dementia. Most are over the age of 65 but 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 Macclesfield District General Hospital. It is approximately one mile from Macclesfield town centre. A car park is provided for visitors, and a local bus service runs close to the home for people reliant on public transport. The accommodation is laid out in 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. The weekly fee payable at the home ranges from £417 to £620. The registered manager provided this information on 3rd July 2006. Hollins Park Nursing Home DS0000018801.V298960.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place on 3rd October 2006. The total time taken for the visit to the home was 7 hours. The inspector spoke with the deputy manager (the home manager was on holiday), residents and staff on all of the units, and two sets of visitors who were at the home during the time of this visit. Records for three residents were examined to check the care they were receiving. Completed CSCI comment cards were received from the relatives of two residents, and also from a community psychiatric nurse and a physiotherapist who visit the home. Their comments were positive. Records, documents, policies and procedures of the home were checked and a tour of the home was undertaken. What the service does well: What has improved since the last inspection? Hollins Park Nursing Home DS0000018801.V298960.R01.S.doc Version 5.2 Page 6 The home has produced satisfaction survey forms that have been sent out to the relatives of the residents in order to find out what they think about the quality of the care, and general satisfaction with the home. A number of these have been returned filled in, indicating that the majority of relatives are positive about the quality of the services provided. Products that are hazardous if used incorrectly were stored securely, so reducing the risk to residents should they have access to them. At the time of the inspection there was no unpleasant smells in the home. The absence of such smells provides a more pleasant environment for the residents. 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 DS0000018801.V298960.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 Hollins Park Nursing Home DS0000018801.V298960.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health needs of the residents are fully assessed before they move into the home to ensure their needs can be met. EVIDENCE: The care records of three people who had moved into the home since the last inspection were examined. All three contained a record of a pre-admission assessment that had been carried out by a trained nurse employed at the home. The assessments were based on the activities of daily living and identified health and social needs and abilities. Problems/needs identified at assessment time were included in the care records of the residents together with plans of care detailing how these problems/needs were to be addressed. Hollins Park Nursing Home does not provide intermediate care so Standard 6 does not apply. Hollins Park Nursing Home DS0000018801.V298960.R01.S.doc Version 5.2 Page 9 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 & 10 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The care records of the residents and the management of medicines need improving to ensure that the healthcare needs of the residents are fully met EVIDENCE: The care records of three residents were examined at this inspection. They all contained written assessments with regard to continence, safe moving and handling, nutrition, and skin integrity. Plans of care had been devised for the needs of the residents that identified the problem, the nursing care and the desired outcome. However, one of the residents had significant needs that had not been included in their care plans. Therefore, it was not possible to see how these needs were being met. All of the residents are registered with a general practitioner and have access to NHS facilities. Records were maintained in the residents’ care files showing that other healthcare professionals are involved in the care of the residents. Hollins Park Nursing Home DS0000018801.V298960.R01.S.doc Version 5.2 Page 10 A medicine administration round was observed during the inspection. This appeared to be well managed apart from that the nurse was seen to dispense medicines directly from the blister packs into their hand and not into a container prior to these being administered to the residents. This practice should be avoided, as it does not follow medication policy guidelines. It was also noted that care staff were given medicines to administer to residents out of sight of the trained nurse. This is also contrary to good practice, as nurses dispensing medicines for a resident should witness that they have taken these before signing their Medicine Administration Record sheets. A random sample of medicines was checked for stock reconciliation and was found to be correct. However, accurate records had not been maintained of a strong pain relief medicine that was prescribed for one of the residents. The amount of medicine delivered to the home in June 2006 had not been recorded as being received so the balance of recorded medicine was different than that in stock. Staff were seen to knock on doors before entering bedrooms and heard to address the residents appropriately. The home has a policy on maintaining dignity and privacy that is available to the staff. Privacy screening is in place in the shared bedrooms and also in place in the bathrooms. Hollins Park Nursing Home DS0000018801.V298960.R01.S.doc Version 5.2 Page 11 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Daily life is varied for the residents with a choice of daily activities and meals, thereby offering choice and stimulation for residents. EVIDENCE: An activities programme was on display that included manicures, flower arranging, art, games, and a walk in a local park (weather permitting). Arrangements had been made for an entertainer to visit the home on 13th October 2006. Residents appeared happy and comfortable, and visitors spoken with said that they are made to feel welcome when visiting, and that they are kept informed of any changes in their relative’s condition. A church service takes place at the home on a regular basis and is open to anyone who wishes to attend. The deputy manager and one of the trained nurses have recently completed a training course on equality and diversity, and the home has policies that are available to the staff on various religious beliefs and customs. Residents and visitors spoken with were positive in their comments about the standard and quality of food provided. The home’s menus appeared varied and nutritious in content. Lunch on the day of inspection was a choice Hollins Park Nursing Home DS0000018801.V298960.R01.S.doc Version 5.2 Page 12 between steak and potato pie, cauliflower and peas or beef curry and rice. Rice pudding or stewed apple and custard was served as a dessert. Hollins Park Nursing Home DS0000018801.V298960.R01.S.doc Version 5.2 Page 13 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 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff have the knowledge and awareness required to prevent the residents from being at risk of harm. EVIDENCE: The home has a complaints procedure that advises people how to make their concerns known. There have been no recorded complaints received at the home since the last inspection. A copy of the complaints procedure was on display. Staff spoken with displayed a good awareness of their role in protecting vulnerable people, and also of what action they would take if they witnessed or suspected that abuse was taking place. The manager provided information that identified training in the protection of vulnerable adults was being planned. Hollins Park Nursing Home DS0000018801.V298960.R01.S.doc Version 5.2 Page 14 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 21 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment is well maintained, providing residents with comfortable, safe surroundings in which to live. EVIDENCE: The home has enclosed gardens that are accessible to the residents. These were well maintained and supplied with garden furniture. A number of bedrooms were visited on both floors of the home. Most had been personalised with photographs and ornaments by the residents or members of their families. Two lounges and separate dining areas are provided on both floors, and these were comfortably furnished. A range of bathing facilities (baths and showers) is located in various parts of the home. All areas of the home visited at this inspection were found to be clean, tidy and free from unpleasant smells. Hollins Park Nursing Home DS0000018801.V298960.R01.S.doc Version 5.2 Page 15 There were plastic jugs in some of the bathrooms. Staff said these were used when shampooing residents’ hair but there was nothing to identify that this was what they were to be used for. The deputy manager said that steps would be taken to ensure that the jugs were not used for any other purpose so there would be no risk of any cross infection or contamination. Hollins Park Nursing Home DS0000018801.V298960.R01.S.doc Version 5.2 Page 16 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although staff receive training to enable them to increase their skills and knowledge, they need to receive updated training in safe moving and handling so they and the residents are not at risk of injury. The home’s recruitment procedures ensure that residents are protected. EVIDENCE: A review of the staffing rotas showed that there are sufficient numbers of staff on duty to meet the needs of the residents’. There are sufficient trained nurses on the rota. Eight of the care staff have achieved an NVQ level 2 in care with a further ten care staff currently undertaking training leading to this award. The company’s infection control nurse was carrying out training with the staff on the day of the inspection and was booked to return the following day to provide training for the remainder of the staff. Other staff training scheduled included focusing on relationships and emotional care (11.10.06) and understanding the system for the administration of medicines (06.12.06). The home manager provided information on training that has taken place within the past twelve months, e.g. end of life care, non-violent crisis intervention, protection of vulnerable adults and wound care. However, there was no record available to demonstrate that all of the staff have received training in safe moving and handling practices within the past twelve months. Hollins Park Nursing Home DS0000018801.V298960.R01.S.doc Version 5.2 Page 17 The personnel files of three staff employed since the last inspection were examined. All of these contained the appropriate documentation, i.e. two satisfactory references, completed application forms, and a record of the staffs’ contracted hours. Evidence was seen of satisfactory Criminal Records Bureau disclosures being obtained for the staff. A record was also seen of all the trained nurses maintaining their registration with the Nursing and Midwifery Council. Hollins Park Nursing Home DS0000018801.V298960.R01.S.doc Version 5.2 Page 18 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 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The opinions of the residents and their families are taken into account about the services provided to make sure their needs are being met. EVIDENCE: The registered manager is a trained nurse who has been in post for a number of years. Staff spoken with commented that they are supported, and that they are enabled to speak openly and express their opinions. Satisfaction surveys were sent out to the families of the residents in June 2006; twenty have been returned. The majority of these were very satisfied, e.g. “I cannot praise the staff enough” and “I have been pleased with the care offered by the home”. Where people had noted something that could be improved, they said that this had been attended to at the time it was mentioned. Hollins Park Nursing Home DS0000018801.V298960.R01.S.doc Version 5.2 Page 19 The home keep a set amount of money for each resident that is used to buy personal items. The money of each resident is kept in an individual wallet with a record of any transactions that are made, signed with the initials of the staff making withdrawals. The cash records of four residents were checked and found to be correct. Information received from the manager prior to this inspection showed that the fire safety systems at the home are tested on a regular basis, and that the gas safety certificate was valid until November this year. Hollins Park Nursing Home DS0000018801.V298960.R01.S.doc Version 5.2 Page 20 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 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 3 X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Hollins Park Nursing Home DS0000018801.V298960.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No 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 15(1) Timescale for action Suitable plans of care must be in 13/11/06 place addressing all of the identified needs of the residents in relation to their health and welfare. The registered person must 13/11/06 ensure that medicines are administered in a safe and appropriate manner. The registered person must 30/10/06 ensure that accurate records are maintained of all medicines received into the home. The registered person must 13/11/06 ensure that staff employed at the home receive safe moving and handling training at least once a year. Requirement 2. OP9 13(2) 3. OP9 13(2) 4 OP29 13(5) RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Hollins Park Nursing Home DS0000018801.V298960.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich 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 DS0000018801.V298960.R01.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!