Inspection on 23/01/06 for Hollins View Community Support Centre

This inspection was carried out on 23rd January 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

Hollins View Community Support... 19/07/07

Hollins View Community Support... 06/07/06

Hollins View Community Support... 06/07/05

Hollins View Community Support... 14/12/04

Hollins View Community Support... 25/06/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Hollins View Community Support Centre Hollins View Clarke Terrace Macclesfield Cheshire SK11 7QD Lead Inspector Sue Dolley Unannounced Inspection 23rd January 2006 10.20 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 View Community Support Centre DS0000036942.V271862.R02.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Hollins View Community Support Centre DS0000036942.V271862.R02.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Hollins View Community Support Centre Address Hollins View Clarke Terrace Macclesfield Cheshire SK11 7QD 01625 534842 01625 503698 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) Cheshire County Council Christina Patterson Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40), Physical disability (5) of places Hollins View Community Support Centre DS0000036942.V271862.R02.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 40 service users to include: * Up to 40 service users in the category of OP (old age not falling within any other category) * Up to 5 service users in the category of PD (physical disability) aged between 55 and 64 years The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidelines which may be issued through the Commission for Social Care Inspection 6th July 2005 2. 3. Date of last inspection Brief Description of the Service: Hollins View is a Community Support Centre owned and managed by Cheshire County Council. The home is close to the centre of Macclesfield and offers long term, short term and respite services for a total of 40 service users along with twenty day care places on weekdays and five day care places at weekends. The premises provide accommodation on two floors.Part of the ground floor has been adapted to provide office accomodation for the home and for the community based services that operate from the building. Access between the ground and the first floors is via a passenger lift. The garden is accessible to service users.The service is mainly for older people aged 65 years plus and may provide care for up to 5 people with physical disabilities provided that the total number of service users does not exceed 40. Hollins View offers a wide range of care services, to cater for a range of individual needs. Bedrooms are situated on both floors and are single rooms with wash hand basin facilities. Four bedrooms have ensuite facilities.Individual bedrooms are personalised, comfortably furnished and lockable. All bedrooms , bathrooms and communal areas are fitted with an emergency call system. There are several specially equipped bathrooms. The home is very busy and has a quickly changing population of service users who stay for between a day and two weeks usually, sometimes returning for further short periods as necessary. Hollins View Community Support Centre DS0000036942.V271862.R02.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 23rd January over a period of 6 hours to assess if service users’ needs were being met. A tour of the premises included, shared areas such as lounges and dining areas, shared bathrooms and toilets, the kitchen and laundry. The manager, several members of staff, health professionals and 4 service users were spoken to during the inspection. What the service does well: What has improved since the last inspection? Since the last inspection the registered manager has completed the Registered Managers Award, much staff training has taken place and more has been planned. Care folders have been updated. There is now a full complement of staff and there has been a smoking awareness campaign. All bedroom and corridor lights have been replaced and corridor areas are now much brighter. There are plans to update one bathroom by installing an electrically operated bath and plans to create a new shower room. Impervious flooring is to be added to three bedrooms in the near future. Hollins View Community Support Centre DS0000036942.V271862.R02.S.doc Version 5.0 Page 6 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 View Community Support Centre DS0000036942.V271862.R02.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hollins View Community Support Centre DS0000036942.V271862.R02.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 4 The statement of purpose needs to be amended to provide clear and accurate information to service users. The home aims to provide intermediate care, respite care, and day care at times to suit individual demand and offers a very flexible service to older service users with a range of care needs. EVIDENCE: Hollins View has a statement of purpose which provides information to service users. The information to service users about visiting arrangements and keeping contact with family members and friends is not clear and should be rewritten. The document needs updating to reflect the involvement of a senior nurse practitioner and occupational therapist within the centre. The information provided about the range of activities available is inaccurate and needs to reflect the current situation, as opportunities for social activities are limited. See Recommendation 1. Hollins View Community Support Centre DS0000036942.V271862.R02.S.doc Version 5.0 Page 9 A separate and colourful service user guide provides clear, concise, easy to read information to explain the service, the accommodation and care provided. It also contains information about how to comment or complain about the service. There is a useful welcome/information pack available to help service users familiarise themselves with the facilities and the service provided. Prior to a short stay being agreed a social services representative prepares an assessment of need and potential challenge to admission, which is forwarded to the residential care co-ordinator and converted, to a care programme. A care programme pen picture is completed and this includes personal information. Staff members have access to this and it is kept confidential in the duty office, is shared with staff at handover times and can be shared with District Nurses when necessary. Care programmes are agreed with each service user and care needs are regularly reviewed to ensure changing needs are met. Community-based nurses and other health professionals may provide support to service users during their stay. The centre is equipped to meet the care needs of older service users and the care files showed that appropriate referrals for specialist medical and therapeutic care are made. Four care files were checked. One person had been admitted beyond the categories of registration, they clearly had a long -standing diagnosis, of Alzheimer’s disease. The care records did not indicate the key worker for each of the service users and one file did not include sufficient information regarding a pressure area to inform staff and to ensure continuity of care. See Requirement 1 and Recommendation 2. Hollins View Community Support Centre DS0000036942.V271862.R02.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9 and 11 Several unexplained gaps in the medication administration records indicate a need for careful and accurate recording and close monitoring of recording to ensure service users receive the correct medication. The management team and senior care staff are very experienced in the care of older people. In the event of a death, all concerned can be assured that they would be treated with care, sensitivity and respect. EVIDENCE: All the medication administration records were checked. Despite evidence of some good practice in monitoring the recording and administration of medication and checking stock levels there were still many unexplained gaps in recording and some medication was not given at the frequency prescribed. Medication to be given ‘when required’ was being recorded in various ways by staff and not according to the guidance provided. One record did not include the telephone contact number of the G.P. and three records did not include a photograph of the service users to aid identification. See Requirement 2. Hollins View Community Support Centre DS0000036942.V271862.R02.S.doc Version 5.0 Page 11 Where service users were able to self -administer medication this had been agreed and risk assessments had been undertaken. Staff members were available to monitor, advise and assist whenever necessary and each service user has a lockable space in which to store medication. The management team and senior care staff are very experienced in the care of older people, and would support and supervise care staff in handling seriously ill and dying service users with dignity and sensitivity. There is a policy and procedure in place to provide guidance to staff in the event of a death. Although the centre is currently used for short stay/ respite care and residential intermediate care staff ensure they have sufficient contact information and/or information regarding service users wishes regarding death and dying should an unexpected death occur. Two care files checked did not record the service users religion and advice was given at feedback regarding this. Hollins View Community Support Centre DS0000036942.V271862.R02.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 There are limited opportunities for leisure and recreational activities to suit service users’ expectations, preferences and capacities. EVIDENCE: Service users confirmed that they have the opportunity to exercise choice in relation to routines of daily living, meals and mealtimes. At present, activities for day care service users and short stay service users are organised separately with occasional joint activities taking place. One senior community support worker is currently undertaking training to enable her to offer activities related to chair based exercises but in general there is a lack of planned and organised activity for short stay service users to suit service users’ expectations, preferences and abilities. Comments within the quality standards questionnaires and discussions with service users confirmed a lack of social and recreational activities. See Recommendation 3. Hollins View Community Support Centre DS0000036942.V271862.R02.S.doc Version 5.0 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): 17 Hollins View can facilitate access to available advocacy services to assist service users and their supporters when they need help in protecting their legal rights. Printed information should be made available to advise service users of local advocacy services. EVIDENCE: All service users have named social workers. They can advise and liaise with advocacy services. At present Hollins View does not provide service users and their relatives with contact telephone numbers and addresses of organisations from which advice and support can be obtained. See Recommendation 4. The community support centre offers predominantly short stay care and therefore has limited involvement in promoting the civil rights of service users to vote and take part in the political process. Hollins View Community Support Centre DS0000036942.V271862.R02.S.doc Version 5.0 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): 22, 24 and 26 Rooms are well furnished and specialist equipment is available to assist service users to maximise their independence and make their stay comfortable. Hollins View is clean, welcoming and inviting. EVIDENCE: The location and layout of the centre is suitable for the needs of the service user group. A programme of routine maintenance, renewal and redecoration ensures the environment is well maintained. Service users spoken with during the inspection confirmed that bedrooms are clean and comfortably furnished and that the there is a good standard of housekeeping to maintain a clean and fresh environment. Ample communal space is provided. The lounges are homely and varied in size. This enables service users to have a choice of where to socialise, sit and relax. Toilets for service users are situated throughout the centre, many of them Hollins View Community Support Centre DS0000036942.V271862.R02.S.doc Version 5.0 Page 15 close to lounge and dining rooms. One bathroom is to be updated by installing an electrically operated bath and there are plans to create a new shower room. Since the last inspection all bedroom and corridor lights have been replaced and corridor areas are now brighter. The doors to toilet and bathroom areas are painted red to aid identification. The bedroom accommodation meets minimum space requirements. Five bedrooms are to have impervious flooring instead of carpet. This will help to promote and maintain to promote hygiene. See Requirement 3. All bedrooms are centrally heated and bedrooms doors have locks, which can be overridden in an emergency. Service users may have a key to their rooms on request and lockable storage space is provided. The laundry and kitchen areas were checked and were orderly and clean. Protective clothing was available for use and policies and procedures and guidance were in place to inform staff about maintaining a safe environment. Adjacent to the main lounge and dining area there is a hairdressing area. Unlike the rest of the centre this area was untidy and cluttered. Additional storage for linen towels etc. to this area may help to overcome this. See Recommendation 5. Hollins View Community Support Centre DS0000036942.V271862.R02.S.doc Version 5.0 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): 30 Staff members are keen to undertake training to inform their practice and ensure competence. EVIDENCE: The staff team have been keen to undertake and complete training. Recently there has been training on maintaining care folders, safer handling, fire-safety awareness, adult protection and on smoking awareness. The staff team continue to achieve NVQ qualification. Several of the management staff and care staff have recently been involved in training related to dementia care. The centre is well staffed at present and there is competent and confident staff team in place. Hollins View Community Support Centre DS0000036942.V271862.R02.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32 and 38 The home is well run by an experienced manager and competent staff team. There are clear lines of accountability within the home, which, helps to ensure that service users’ best interests are safeguarded and the health, safety and welfare of service users and staff are promoted and protected. EVIDENCE: The locality manager is responsible for the community support centre and heads the management team. The registered manager is experienced in the provision of care for older people with relevant qualifications for the post and a pro-active approach to progress and improvement of facilities and services within the centre. The registered manager completed the Registered Managers Award in the latter part of 2005 and awaits the certificate of qualification. The centre is soon to host an award/presentation ceremony for NVQ qualification. Hollins View Community Support Centre DS0000036942.V271862.R02.S.doc Version 5.0 Page 18 The registered manager is supported by care co-ordinators. There are clear lines of accountability and responsibility within the centre. The management team members are open to constructive criticism and respond well to suggestions for improvement for the benefit of service users and staff. The management approach of the home creates an open, positive and inclusive atmosphere. At the beginning of the inspection the registered manager was not available within the building and senior staff were observed to undertake their duties in a well-organised, thorough and responsible manner demonstrating their abilities and competence. The centre’s management team ensure that staff receive a suitable induction, including training on moving and handling, fire safety and infection control, and a detailed training schedule for each member of staff is retained. The registered manager ensures that risk assessments are carried out and recorded in respect of all safe working practice topics. The accident records were checked and accidents were thoroughly recorded except that several accident records had not been signed by the registered manager to show awareness. Advice was given regarding this at feedback to the inspection. The fire policies and procedures manual was checked and provided evidence of satisfactory fire safety checks and training. Despite the registered manager providing written and verbal reminders to care and domestic staff, bedroom doors are being propped open. During the inspection four bedroom doors were found propped open with waste paper bins. There is an intention to fit hold open devices with automatic closures. Until this happens staff must ensure that bedroom doors are not propped open. See Requirement 4. In checking the premises, items of discarded furniture were seen within the courtyard. These should be removed. See Recommendation 6. Hollins View Community Support Centre DS0000036942.V271862.R02.S.doc Version 5.0 Page 19 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 2 X X 2 X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 1 10 X 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 2 18 X X X X 3 X 3 X 3 STAFFING Standard No Score 27 X 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X X X X 2 Hollins View Community Support Centre DS0000036942.V271862.R02.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 14 & 24 Requirement Timescale for action 2 OP9 13 a). The registered person must not provide accommodation to a service user at the care home 28/02/06 unless, so far as it has been practical to do so there has been appropriate consultation regarding the assessment with the representative of the service user. b). The registered person has confirmed in writing to the service user that having regard to the assessment the care home is suitable for the purpose of meeting the service user’s needs in respect of his health and welfare. 14 and section 24 of the Care Standards Act 2000 The registered person must make arrangements, for the recording, handling, safekeeping, safe administration and disposal 28/02/06 of medicines received into the care home. (Similar requirements were made at two previous inspections on 14/12/04 and 6/07/05). Hollins View Community Support Centre DS0000036942.V271862.R02.S.doc Version 5.0 Page 21 3 OP24 16 4 OP38 23 Provide adequate floor coverings to three service users bedrooms. (This requirement remains unmet from the previous inspection on 6/07/05) Staff must ensure that bedroom doors are not propped open, and were necessary hold open devices with automatic closures must be fitted. (This requirement remains not met from the two previous inspections). 30/04/06 30/04/06 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 Refer to Standard OP1 Good Practice Recommendations Ensure the statement of purpose is corrected to provide clear and accurate information to service users. (This recommendation has not been actioned from the previous inspection on 6/07/05). Ensure care records are fully completed with all pertinent information to include details of key workers involved and with sufficient information to describe any health matters for example, the incidence of pressure areas. Arrange planned and organised activity for short stay service users to suit their social and recreational needs, expectations, preferences and capabilities. (This recommendation has not been actioned from the previous inspection on 6/07/05). Provide service users and their supporters with printed information about local advocacy services available. Ensure the hairdressing area is tidy in keeping with all other areas of the centre. Ensure discarded items of furniture are removed from the internal courtyard area. 2 OP4 3 OP12 4 5 6 OP17 OP26 OP38 Hollins View Community Support Centre DS0000036942.V271862.R02.S.doc Version 5.0 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 View Community Support Centre DS0000036942.V271862.R02.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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