Inspection on 01/05/07 for Holly Bank House

This inspection was carried out on 1st May 2007.

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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Holly Bank House 13/01/09

Holly Bank House 21/08/06

Holly Bank House 10/01/06

Holly Bank House 12/07/05

Holly Bank House 08/03/05

Holly Bank House 21/06/04

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

CARE HOME ADULTS 18-65 Holly Bank House Coltham Road Short Heath Willenhall West Midlands WV12 5QB Lead Inspector Mr Ian Harris Key Unannounced Inspection 1st May 2007 08:00 Holly Bank House DS0000036419.V337398.R01.S.doc Version 5.2 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 Holly Bank House DS0000036419.V337398.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 Adults 18-65. 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. Holly Bank House DS0000036419.V337398.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Holly Bank House Address Coltham Road Short Heath Willenhall West Midlands WV12 5QB 01922-710524 01922 493250 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) Walsall Metropolitan Borough Council Neil Farrington Care Home 21 Category(ies) of Physical disability (21) registration, with number of places Holly Bank House DS0000036419.V337398.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Holly bank House is a single storey purpose built residential home located in the Short Heath area of Walsall. The home was commissioned in 1984 and is owned and managed by Walsall Metropolitan Borough Council. It provides accommodation for adults with physical disabilities and is suitably adapted to meet their needs. Holly bank is conveniently situated for the local shops, the health clinic and a public house. The building is divided into three units, one of which is made up of seven self-contained bed-sits with bathroom and kitchen facilities. The remaining two units each have seven bedrooms with a shared sitting room, dining room and kitchen. Both units also have shared toilets, bathroom and shower facilities. The charges at the home are £738.00 per week. Holly Bank House DS0000036419.V337398.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was an unannounced key inspection and took place over 5 hours. During the inspection a tour of the premises took place and staff and care records were inspected. Also staff rotas and general records regarding the maintenance of the home were checked. 3 members of staff and 4 residents were spoken with. Three case files were selected for case tracking, relevant documents were inspected and discussions were held with residents, and members of staff. Observation was made of the various daily activities. Other information was gathered prior to the inspection, which included Fire officers and environmental health reports, and notification. What the service does well: What has improved since the last inspection? The new care manager has made a very positive impact on the quality of the service provided and has addressed all the recommendations and requirements Holly Bank House DS0000036419.V337398.R01.S.doc Version 5.2 Page 6 that is within his power. The outstanding requirements will need further financial input from the Local Authority. A considerable amount of work has taken place since the last inspection. The home has a rolling programme of maintenance and since the last inspection two bedrooms have been redecorated. The replacement of the lighting fittings throughout the building has improved the quality of light for the residents, a new hot water system, which ensures all residents are provided with hot water, the provision of electronic door system that gives residents easy access to external doors and the provision of a visitors- room, which provides residents privacy when they meet with visitors Considerable amount of work has taken place to improve the residents care plans, which now include risk assessments and nutritional screening. This ensures that the staff are able meet the individual needs of 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. The summary of this inspection report can be made available in other formats on request. Holly Bank House DS0000036419.V337398.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Holly Bank House DS0000036419.V337398.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. No prospective resident is admitted to the home until their needs have been properly assessed. Residents are fully involved in the assessment process and are given the opportunity to meet staff and view the home before making any decisions to move in. The home provides good clear information about the services provided to assist people to make an informed decision about moving into the home. EVIDENCE: There is evidence on the files that all the residents who are funded by the Local Authority undergo a full multi-disciplinary assessment prior to admission. The residents, who are self funding are assessed by the Care Manager, using the homes assessment forms. three case files were selected for inspection and included files of people recently moving into the home for respite and on a permanent basis. Pre admission details were included in the files together with a record of trial visits to the home. There is evidence on file of a prospective resident undergoing a phased admission, which include a trial weekend visits to the home. The home has a good service users guide that is available to prospective residents, which enables a resident to make an informed decision about the services provide. Holly Bank House DS0000036419.V337398.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8, and 9 This quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care plans are of good quality, person centred and are agreed with the individual resident. Residents are consulted on a regular basis to gather information about their care EVIDENCE: The home provides a comprehensive care plan for each individual resident, which is written in plain language, easy to understand and based on the initial assessment. The Care Plans are drawn up by the Care Staff in consultation with the resident and their family. Care plans are being carried out and reviewed on a regular basis. Residents are consulted regarding their care at reviews, residents meetings and through their key-worker. Three residents confirmed that staff consult them regarding their care. It was also noted the residents have been encouraged to form a residents committee in order to encourage residents to be more involved in decision making. Residents spoken with stated that they decided what they wanted or not wanted to do and at Holly Bank House DS0000036419.V337398.R01.S.doc Version 5.2 Page 10 what time. This was confirmed by the fact that, sometimes residents decided not to attend the day centre or college. Holly Bank House DS0000036419.V337398.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11- 17 This quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to pursue social activities within and outside the home, in keeping with their own interests and capabilities. Family and friends are able to visit when they wish and meet their relatives in comfort and privacy. The meals in the home are good, offering choice and variety, and also catering for special dietary needs. EVIDENCE: The Home works hard to encourage residents to be involved in a range of leisure opportunities, consistent with each resident’s capabilities. Service users have opportunities to go to Day Centres or Colleges in the local community. One person is enrolled for an art and poetry class at College, whilst another is attending a regular dancing class. Residents are encouraged to maintain as much independence as possible and the home has a good range of equipment to assist residents. Holly Bank House DS0000036419.V337398.R01.S.doc Version 5.2 Page 12 The Manager stated that the residents are positively assisted and helped to exercise choice and control regarding activities by their key-worker and there is evidence that regular residents meetings take place to obtain feedback, which includes activities and menus. The home has its own transport that is a great advantage and gives the residents easy access to the wider community. It was also noted that a number of the more mobile residents have bus passes in order to use public transport. A close liaison is maintained with the relatives and representatives and a good number of residents spend weekend at relatives’ homes. Residents confirm that their friends and family are able to visit at any reasonable time and the home now provides a very comfortable visitors room. There is also contact with local churches and visiting clergy. One resident attends a church and an Afro-Caribbean resident attends the Black Sisters community group. All residents’ comments were very complimentary about the standard and choice of food provided and they stated they are consulted about menu changes. It was noted that the menu for the main meal of the day is changed to incorporate seasonal variations. Occasionally take-a-ways are brought into the home. The home is planning theme meals such as Italian or Greek meals. Residents can choose where to eat their meals and during the inspection some chose to eat together, while others ate in their rooms. The kitchen was seen during the inspection and was found to be clean and in good order. There were plentiful supplies of food. The cook confirmed that fresh vegetables and fruit were supplied on a regular basis. The temperature of the cooked foods is taken and records were seen to verify this. There is evidence that fridge and freezer temperatures are taken. Holly Bank House DS0000036419.V337398.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, and 20 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident health needs are being well met through contact with local G.P. s. local hospitals and paramedical services. The systems for the administration of medication are good with clear and comprehensive recording arrangements being in place to ensure resident’s are assisted with their medication needs are met. EVIDENCE: The home is well supported by local G. P. s. and all of the paramedical services. Wherever possible, the residents are encouraged to retain their own G. P s, Opticians, and Dentists. It was noted that if the resident has moved out of their own home area the Care Manager ensures that these services are provided by local practitioners. The records indicate that resident’s medical needs are being met this was confirmed by three residents. All but two residents are assisted to self medicate by means of a Boots monitored dosage system, which is supplied by the local Boots chemist. The system is working well, and ensures medications are handled safely and residents get the medications they have been prescribed. The home receives good support from Holly Bank House DS0000036419.V337398.R01.S.doc Version 5.2 Page 14 the Boots pharmacist who does a three monthly audit of the homes medication. All care staff have been trained to use the system and undertake Safe Handling of Medicines Aset training before they are allowed to administer medication. Various items of equipment are provided in the home to assist service users to be as independent as possible. The enabling of independence is of high priority to the Manager and this has been communicated to the staff and residents. Some feel very positive about this. One resident said that this was “exciting” and welcomed the opportunity to take a fresh look at the way things were done in the home. Particular attention is given to ensuring privacy and dignity when delivering personal care. Observation of the working practices of two carers throughout their morning shift confirmed they were courteous and attentive to the individual needs of the people living at the home. All of residents seen were well groomed and attired. Two of the residents said the staff are very helpful and cheerful and cared for them well. Holly Bank House DS0000036419.V337398.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and others involved with the home understand how to make a complaint and are clear about what will happen if a complaint is made. Residents are well protected by a robust prevention of abuse policy and procedure. EVIDENCE: The home has a good comprehensive complaints procedure. The residents and relatives are made aware of the procedure through the statement of their terms and conditions of residence, the service users guide, of which a copy is placed in every bedroom and on the notice board in the reception hall. A number of residents stated if they had any problems they would know who to speak to if they wished to make a complaint and they also felt that they would be listened to. It was noted that the home has received one formal complaint since the last inspection, which is currently under investigation. All minor complaints are dealt with appropriately and quickly. The home has new policies and procedures regarding Prevention of Abuse which includes a Whistle-Blowing policy, which meets national and local guidelines. These issues are also covered in external and N.V.Q. training. Seven care staff are booked on Adult protection training into the new policies and procedures. Holly Bank House DS0000036419.V337398.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 27, and 30 The quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The overall outcome for this group of Standards is judged to be Adequate. The building is clean and tidy but is tired and outdated and needs refurbishment in several areas. EVIDENCE: Holly bank is now 23 years old and the building does not meet modern day standards. 14 of the 21 rooms do not have an en suite facility and do not meet today’s space requirements of 15 sq. metres. There are no separate premises for short stay residents, however several stay at Holly bank on a regular basis and know the other residents well. Many areas of the building are in need of extensive refurbishment and redecoration. All the bathrooms are drab and uninviting. Some bedrooms have been redecorated, but many are badly in need of some attention. There is a lot of wheelchair damage around the building, which is inevitable, but some of the damage to corridors, doors and bedroom walls is making the building look run down. The carpets in Holly Bank House DS0000036419.V337398.R01.S.doc Version 5.2 Page 17 the corridors of C Block have been damaged by bleach and need to be replaced. The home has a large laundry. There are two industrial washing machines, one of which has a sluicing facility. There has been considerable work carried out in the home since the last inspection, which includes the provision of a visitors’ room, which provides residents privacy when they meet with visitors, the decoration of two residents’ bedrooms, which has improved their environment. The replacement of the lighting fittings throughout the building, that has improved the quality of light for the residents, a new hot water system, which ensures all residents are provided with hot water, and the provision of electronic door system to give residents easy access to external doors During the inspection, the home was found to be clean, tidy and free from any unpleasant odour. The home has good policies and procedures in place regarding infection control. The manager stated that the majority of staff have now received training in infection control and they are made aware of the dangers of cross-infection. Holly Bank House DS0000036419.V337398.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 and 36 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to fulfil the aims of the home and meet the changing needs of residents. These staff are recruited and trained properly and this helps to ensure that residents are safe and well cared for. The staff have regular opportunities to develop their knowledge and skills through external and internal training. EVIDENCE: The inspection of staff rotas and discussions with staff and residents indicated that the home is well staffed with the minimum of 4/5 care assistants and two managers on each shift. There is a good balance within the staff group, which includes experience, mature and younger staff who are embarking on a new career. It was noted that there have been minimal staff changes since the last inspection. However it was noted that the home has two vacancies for care staff that are being covered by agency staff. These posts should be filled quickly with permanent staff members. Holly Bank House DS0000036419.V337398.R01.S.doc Version 5.2 Page 19 Discussions with four residents confirmed they thought the staff were respectful and helpful and said that they were happy with the way they were cared for by the staff. Observations of staff carrying out a variety of tasks appeared to confirm they are clear regarding their role and what is expected of them. The files of six members of staff was seen which showed that recruitment checks are being carried out there was evidence that all Criminal records checks are being carried out. Evidence of induction and initial mandatory training was seen. The home has a good training programme. Staff confirmed that training is provided and there are many opportunities to improve their knowledge and skills for the benefit of service user care. All staff at the home are committed to developing their knowledge and skills through training and have regular opportunities to do so through external and internal training activities. The home has a programme of N.V.Q. training that has exceeded the minimum standard. In addition to the mandatory training care staff have received training in Epilepsy Awareness, Huntington Disease, Managing Incontinence and Fire Wardens Training. Holly Bank House DS0000036419.V337398.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, and 40 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed by a competent registered manager, where service users interests and welfare is promoted. The health, safety and welfare of the service users and staff are promoted by the home’s policies and procedures. EVIDENCE: The Care Manager has obtained the Registered Manager’s Award and has considerable experience in caring for people with disabilities. There are clear lines of accountability within the home and the manager is very supportive of both staff and residents. During the inspection there was a staff training session taking place and it was observed that good team- work and interaction was taking place between staff. Observations made and discussions with residents’ and staff indicated that the Care Manager is very approachable and operates an open door policy. The Holly Bank House DS0000036419.V337398.R01.S.doc Version 5.2 Page 21 residents who could express themselves stated that they are happy to approach the Care Manager and staff with any problems they might have and were confident that they would be responded to. There is a good staff supervision system in place and there is evidence that staff have regular meetings. All the Financial records and administrative procedures within the home that were inspected were found to be well ordered and maintained. The home has a good heath and safety policy and all staff are aware of their responsibilities regarding these issues and a number of staff have received training on these issues Records seen show that fire alarm tests take place each week, emergency lighting tests each month and fire drills at least every six months. Certificates were seen to verify that the fire fighting equipment and fire extinguishers were serviced in 2006. A gas safety check took place in February 2006. There is a 5 year electrical certificate (from 2004) in place. The hoists were serviced in August 2006. The water system was checked for legionella and the system disinfected in 2006. Holly Bank House DS0000036419.V337398.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 2 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 3 X X X Holly Bank House DS0000036419.V337398.R01.S.doc Version 5.2 Page 23 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 YA26 Regulation 23(2)(b) Requirement It is recommended that bathrooms and toilets be updated and refurbished. They are currently drab and uninviting. Damage to skirting boards, doors and walls must be repaired and redecorated. Damaged carpets in corridors must be replaced. ( Previous timescale of 23/08/06 not met) Timescale for action 01/07/07 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 YA30 Good Practice Recommendations It is recommended that the home purchase a sluicing disinfector for the commode pots. Holly Bank House DS0000036419.V337398.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Holly Bank House DS0000036419.V337398.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. 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