Inspection on 13/01/09 for Holly Bank House

This inspection was carried out on 13th January 2009.

CSCI found this care home to be providing an Good service.

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

Holly Bank House 01/05/07

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 27/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Holly Bank House Coltham Road Short Heath Willenhall West Midlands WV12 5QB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Wendy Grainger     Date: 1 3 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Holly Bank House Coltham Road Short Heath Willenhall West Midlands WV12 5QB 01922-710524 01922493250 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Walsall Metropolitan Borough Council care home 21 Number of places (if applicable): Under 65 Over 65 0 physical disability Additional conditions: Date of last inspection Brief description of the care home 21 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. The fees for the service varied from £783 for long term placements, and between £26:80 for under 60 years of age and £102:90 for people over 60years of age requiring respite care . These weekly fees applied at the time of the inspection and the people may wish to obtain up to date information from the service. Care Homes for Adults (18-65 years) Page 4 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The overall quality rating for this service is 2 star. This means that the people who use the service experience good quality outcomes. One inspector carried out this unannounced key inspection on one day between 7:40 and 16:30 hours. The service completed an Annual Quality Assurance Assessment (AQAA). This is a self-assessment tool, which was used as part of the key inspection. The completion of the AQAA is a legal requirement and it enables us to see how well the service focuses on the outcomes of the people to make sure their needs are being met. The AQAA also gives us some numerical information about the service. We were unable to review any Have your say surveys as the manager of the service told us they had not received any. We spoke to a number of the people who use the service to find out their views about what it is to live at the service. Each person spoken with on the day told us that, I keep Care Homes for Adults (18-65 years) Page 5 of 27 coming back for respite, I feel safe here. We looked around the premises to see the standard of comfort and safety. We looked at the menus to assess their standard in terms of meeting peoples needs. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who may wish to use the service and their representatives are given information to enable them to decide if the service will be suitable to meet their needs. Admissions are made after a full assessment has been carried out to ensure peoples needs can be met. Evidence: The services completed Annual Quality Assurance Assessment (AQAA) document provided evidence on the manner people who use the service were admitted. The recently admitted person was an emergency respite stay, who was returning home on the morning of our inspection. We spoke briefly to this person, he told us that, He had been well looked after during the week, and that during his stay, His needs had been met by the staff. We were unable to incorporate any completed Have your say surveys. We were told by the manager that the service had not received any surveys for people to complete. The Statement of Purpose and service users guide identified the service any person could expect and the fees charged for long-term placements and for respite stays. Care Homes for Adults (18-65 years) Page 9 of 27 Evidence: We looked at two care plans, while we evidenced that they had been reviewed, there was a need for the plans to be streamlined to ensure that they were live and active. We saw that there was information that did not relate to the present care which could be confusing to staff caring for this person. We evidenced the handover when details of the morning were passed onto the new staff on duty. This is good practice as it makes sure that all staff have up to date information about each person in their care which enables them to better meet their needs. Care Homes for Adults (18-65 years) Page 10 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals are involved in decisions about their care and lifestyle. Each person has a plan of care based on their individuals needs. Evidence: From what the services completed AQAA told us and from records we saw we found that people who are involved in planning their care. This was further evidenced by peoples signatures we saw on care plans. We discussed with the manager information found in one of the plans. Information recorded was not factual and did not represent any of the interests of this person. Without the information staff may not be aware of these needs and they may not be met. We spoke to a person experiencing a regular respite stay, he was extremely complementary about the service, You cannot fault the place, the staff are fantastic. We saw that there was a range of equipment available for one person, which helps promote their independence and safety. We observed interactions between the staff and the people who use the service each Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: person spoken with was relaxed and comfortable with the contact. We were informed in the completed AQAA and by staff and people that the new key worker system was working. Each person spoken with knew his or her key worker. We discussed with the manager the need for equality and diversity within the present group of people. Dietary needs are met by providing appropriate cultural diets this was evidenced from the menus. One person has strong links with a Black Sisters group, which she willingly attends twice a week. Seven of the people who use the service have home leave on a regular basis. One couple have married recently and the service has made arrangements to accommodate their needs and living area. Care Homes for Adults (18-65 years) Page 12 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to make choices about their lifestyle and develop skills both educationally and socially in the community. Evidence: People who use the service received personal support and care from experienced staff to ensure that their needs were met. Privacy for an individual was evidenced during the inspection for example, we saw staff knocking on a persons door and waiting for a response before entering their bedroom. One person told us, the staff are good I cannot do much for myself. Our observations showed that meal times were relaxed and unhurried. We saw that one person was sensitively assisted with his lunch. Food prepared respected cultural needs of individuals this was evidenced from the menu. We saw that menus were Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: varied and offered an alternative each day. The cost of holidays had been built into part of the services contract. The majority of people choose to go away go with their family. This year one senior staff has escorted two people on a holiday of their choice in this country. Individuals attend college courses and the disabled living centre which promotes learning life skills for example, numerical skills. One person attends a course for social skills awareness. Care Homes for Adults (18-65 years) Page 14 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Medication systems do not always follow policies and procedures or safe practise guidelines to ensure that people are fully safeguarded. The health and personal care that people receive is based on individuals needs. The principles respect the privacy and dignity of individuals Evidence: We identified that the medication was secured in a locked trolley. We saw that the locked Bristol Maid box used for controlled medication was loose within the trolley. We discussed the need to secure this controlled medication in line with the guidelines and gave information about the fittings to be used. We checked the controlled medication and found it satisfactory. The service had polices and procedures in place and staff have accredited training for the handling and administration of medication. This was confirmed in the services completed AQAA and by the staff training records. We evidenced the records for the administration of medication. We found that there were a number of gaps in the records. We were therefore unable to identify if the medication had been administered as prescribed by the persons doctor which if it had not been could place the person at risk to their health. Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: Arrangements were in place for the continued health care of individuals. Transport was provided for appointments in the community. Care Homes for Adults (18-65 years) Page 16 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to express their concerns and have them listened to. Processes are in place to protect the people who use the service from abuse. Evidence: The service has comprehensive information in place informing staff and people who use the service how to raise a complaint or concern with the management. We suggested that the information could be improved upon by adding our contact details so that people could contact us as well if they need to. The manager told us that this would be done. The services completed AQAA told us that the four complaints received which had been addressed to the satisfaction of the people, this was confirmed by the records we saw. Additional staff training in customer care and attitudes had been provided following the addressing of one complaint. People who use the service and staff spoken with told us they were aware of the complaints process and how to use it. I would speak to the staff or my key worker, I know how to complain its in the book. There have been no safeguarding referrals for this service. Care Homes for Adults (18-65 years) Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Whilst the environment is safe, warm, clean and spacious work could be undertaken in some areas to increase comfort and make it more relaxing. Evidence: Located off a busy road the service stands in its own grounds. Purpose built over twenty-years ago the internal design remains the same. Internally the service was dated. We were told there were plans to review the provision and to redesign some areas. The service was a credit to the housekeeping staff as we saw that it was very clean. People who use the service were willing for us to see their bedrooms. Attempts are made to personlise peoples rooms but more consultation with people about for example, colour schemes would further improve this as one person told us. I would like a different colour on the walls but it belongs to Walsall so I dont suppose I can change it. We were told that there were plans to replace the carpets in the bedrooms with laminate type flooring. We suggested that people should be part of the discussions prior to replacement as peoples choice should be considered in the event they preferred an alternative type of flooring. While the bathrooms were clinical in their design and did not provide a restful ambiance for people to relax in they were safe. We were informed by the staff that recently the existing tiles had been overlaid, as documented on the work sheet Care Homes for Adults (18-65 years) Page 18 of 27 Evidence: requirements. The completed tile work in the shower room was very shoddy in its finish. The service has received an award from the local Environmental Health Department for the kitchen and good standards. Equipment is provided to enable individuals independence and promote safety for example, hoists, specalist call systems for individuals and grab rails. We saw that the door guard to one room required attention to ensure it worked effectively in the event of a fire this will help to keep people safer. Care Homes for Adults (18-65 years) Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Trained, skilled and experienced staff are provided in adequate numbers to meet the needs of people who use the service. Recruitment processes need some improvement to show that they are safe and that people are properly protected. Evidence: The services completed AQAA told us that staff training was current and on going. This was confirmed by staff who told us that they received training appropriate to their role. The manager told us that new staff completed an induction, which includes aspects of personal care and covers working policies and procedures. The staff records we looked at identified that staff are supervised on a regular basis, this confirmed the verbal discussions we had with staff and the completed AQAA information. Some information concerning recruitment of staff was not readily available to us to check. Staff confirmed when spoken to that they had been subject to Criminal Records Bureau (CRB) checks prior to employment. Following our inspection we contacted the Human Resources department at Walsall Civic Hall who explained the system in place, which was soon to be changed. The new system will ensure that all the relevant information in relation to staff records would be available at the service. The present practice did not evidence robust recruitment practice and would not give people confidence that it is entirley safe. Care Homes for Adults (18-65 years) Page 20 of 27 Evidence: We observed staff supporting people and found there were positive interactions between staff and people who use the service. We were told by the people, The staff are fantastic I cannot fault them, They do what I want they are very good, I feel safe here. Care Homes for Adults (18-65 years) Page 21 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Management is sound and effective. The service is run in the best interest of those who use it. Evidence: The care manager has had a number of years in the caring profession. He has created an accumulation of documents and audits, which appear to be oversubscribed in places. He has the experience to run the home with experienced staff in the best interest of the people who use the service. Records were maintained ensuring the policies and procedures protected the people who use the service. The manager completed and returned a completed AQAA within the timescale given, the document was informatiive and of a good standard. The records for the staff fire awareness and taking part of a fire drill were current. One person told us I know about the fire bell and what to do which would ensure that this person would know what to do in the event of a fire to keep them safer. People who use the service were encouraged to be self sufficient in respect to their Care Homes for Adults (18-65 years) Page 22 of 27 Evidence: finances. Certificates and information written in the services completed AQAA regarding maintenance for electrical equipment, water, gas appliances told us that they are tested as required by the manufacturers or legislation which helps to increase safety for people who use the service. Policies and procedures we saw are reviewed updated when needed. Care Homes for Adults (18-65 years) Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 2 6 Our contact details should be included in service documents so that people can contact us if they need to. To obtain the feedback in respect of the service provided surveys from stakeholders. To enable the service to collate the information for moving the service forward. To ensure that the care plans were live, active plans containing current information about each person which enables them to better meet their needs. To ensure as good practise that a record is maintained for all the meals prepared and served. To comply with the Misuse of Drugs Regulations the controlled drugs cabinet should be secured to a wall. The home was in breach of the services policies and procedures and the Misuse of Drugs Regulations. To prevent any errors staff need to ensure that medication is administered and recorded to the person as prescribed by their doctor. To ensure that equipment i.e. door guards were working effectively at all times this will help to keep people safer To prevent cross contamination in the laundry alginate Page 25 of 27 3 6 4 5 6 17 20 20 7 8 24 30 Care Homes for Adults (18-65 years) bags should be provided to be used by the people. Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - 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!