Inspection on 09/03/09 for Holly Bank Nursing Home

This inspection was carried out on 9th March 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

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Extracts from inspection reports are licensed from CQC, this page was updated on 10/07/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Holly Bank Nursing Home Manor Heath Road Halifax W Yorkshire HX3 0BG     The quality rating for this care home is:   one star adequate 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: Paula McCloy     Date: 0 9 0 3 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 Older People 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 Older People 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Holly Bank Nursing Home Manor Heath Road Halifax W Yorkshire HX3 0BG 01422368555 01422882822 hollybanknursing@yahoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Patricia Beaumont Type of registration: Number of places registered: James & Reuben Ltd care home 25 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: 1. The registered person may provide the following category of service only: Care Home with Nursing - Code PC to service users of the following gender: Either whose primary needs on admission to the home are within the following categories: Old age not falling within any other category - Code OP 2. The maximum number of service users who can be accommodated is 25 Date of last inspection Brief description of the care home Holly Bank is a care home with nursing. It is locted near Manor Heath Park in Halifax and is approximately 1/2 mile fom the town centre and all of its facilities. There is a car park at the front of the building and seating for people to use in fine weather. Care Homes for Older People Page 4 of 27 Over 65 25 0 Brief description of the care home The accommodation is arranged over three floors. There are single and double bedrooms available and a passenger lift serves all floors. There are two lounges on the ground floor. The property is well maintained and there is an ongoing programme of redecoration and refurbishment. Care Homes for Older People Page 5 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: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. The current weekly charges at Holly Bank range from 450- 520 pounds per week. Additional charges are made for hairdressing, chiropody and newspapers. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use the service are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Care Homes for Older People Page 6 of 27 This is the first inspection of the home since the new owner and manager were registered in December 2008. Under the previous ownership and management the home was assessed by us as being poor. This inspection was carried out to assess the quality of care provided to people living at the home. The inspection process included looking at the information we have received about the home since the last key inspection as well as a visit to the home, which lasted approximately 7 hours. During the visit we spoke to 5 people living in the home, 6 members of staff, the manager and 3 relatives. We also observed staff delivering care, looked at various records and looked around the home. Comment cards were sent to 10 people living in the home, 10 staff and 5 health care professionals; these cards provide an opportunity for people to share their views of the service with us. Information received in this way is shared with the home without identifying who has provided it. Three relatives completed the surveys on behalf of their relative, three members of staff and one health care professional wrote to us with their comments. Their comments have been used in this report. What the care home does well: What has improved since the last inspection? What they could do better: Make sure that people are properly assessed before they move into the home to make sure staff know what their needs are and what action they have to take to meet these needs. Make sure that copies of the Service User Guide are available so that people can have written information about the home and the service that it offers. Make sure that care plans are detailed and tell staff exactly what they have to do to make sure peoples needs are met. This will make sure people get consistent care and support. Make sure that staff training is kept up to date. This will make sure staff are working safely. Care Homes for Older People Page 8 of 27 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People must be properly assessed before they are offered a place at the home. Without proper assessments there is no guarantee that staff will be able to meet their needs. Evidence: The home has a Service User Guide, but copies of this were not available when we visited. The manager must make sure that this document is readily available so that anyone visiting the home can take information away with them to help them decide if they think Holly Bank will meet their needs. Relatives told us that they had been to look around the home. This helped them to decide if the home would be suitable. We looked at the files for two people that had moved into the home most recently, to see what information staff had collected. We found very little information about either Care Homes for Older People Page 11 of 27 Evidence: person. Staff must make sure that they have completed their own written assessment or have an assessment from the placing authority before people move into the home. Without proper assessments there is no guarantee that the home will be able to meet peoples needs. The home does not provide intermediate care. Care Homes for Older People Page 12 of 27 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and personal care needs are being met. Peoples care plans need to be improved to reflect the care and support being given. Evidence: We looked at a selection of care plans because we wanted to see what individual needs had been identified and what action staff are expected to take to meet those needs. The manager is aware the the care plans are not up to date and that they lack detail. There is a new nurse starting work at the home soon. Her role will be to take the lead on care planning and nursing issues. A new care plan format has been devised, which should mean care plans are well organised and easy to follow. People looked well cared for. For example men had been shaved, peoples hair had been combed and their glasses were clean. Peoples health care needs are being identified and met. Staff are vigilant and GPs and Care Homes for Older People Page 13 of 27 Evidence: other health care professionals are being involved as necessary. Details of any visits by health care professionals are clearly documented in the residents care plan, together with the advice that has been given. People living in the home told us that they get the care and support that they need and that staff are available when they need them. Staff told us that they are given enough information about the needs of people living in the home. Staff said the following: We have daily reports at the beginning and end of every shift. The care plans are available for us to look at when required. The medication system is generally well managed. We observed part of a medication round. The nurse spent time with each person, talked to them about their medication and offered encouragement when needed. We could see from the records that people are receiving their medication at the prescribed times and records are well maintained. We did see that staff hadnt booked the medication in when it had arrived in the home. The manager has recently changed the procedure for this and staff should do this on the day the medication arrives in the home. She will be taking this up with the staff concerned. Care Homes for Older People Page 14 of 27 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. 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. There are activities on offer to keep people stimulated. Relatives are welcome to visit at any time. Evidence: There was very little information on peoples care plans about their life history or personal preferences. It is important that this information is recorded as it helps staff to have a better understanding of the individuals that they care for. We did find information about peoples interests and hobbies. The manager is confident that the new care planning system will make sure more information about people is available. People told us that activities are on offer. We saw people really enjoying a sing-song during the afternoon. We also saw that staff have time to sit and talk to people. There was a nice relaxed and friendly atmosphere and some good humoured banter between people living in the home and staff. Relatives told us they are made to feel welcome when they visit. We saw that people are offered drinks and that staff are available to answer any questions they may have. We saw the lunchtime meal being served. The majority of people ate their meal in the dining room. There was a choice of food available. Tables were nicely set and staff Care Homes for Older People Page 15 of 27 Evidence: were available to assist people if needed. People told us that the food is good. They made the following comments: The food is well cooked, varied and plentiful. Staff have listened to requests about food and made sure our relative gets food she can manage. Care Homes for Older People Page 16 of 27 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. 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 know how to make a complaint and are confident that any issues raised would be sorted out. Staff know about adult protection. This means that people in the home are being kept safe. Evidence: The homes complaints procedure is on display. People told us that the know who to talk to if they are unhappy or if they want to make a complaint. Staff told us that if anyone made a complaint or raised a concern they would report it to the manager or nurse in charge. People we spoke to told us that they would be able to raise any concerns with the manager and were confident that any issues would be sorted out. There is a complaints log available so that staff can record any complaints that are received giving details of what the complaint was about, the action that has been taken too sort the problem out and the the outcome. This should make sure that any complaints are dealt with properly. The staff we spoke to were able to tell us what they would do if they felt there were ant practices in the home that werent in the best interest of the people living there. They also said that their National Vocational traioning (NVQ) in care had covered adult protection issues. The manager is aware that some staff need to complete adult protection training to make sure they are fully aware of all of the different types of abuse and about the reporting procedures. The manager is aware of the local reporting procedures and was using these to report an adult protection issue that was Care Homes for Older People Page 17 of 27 Evidence: discussed during the inspection visit, regarding a discharge from hospital. Care Homes for Older People Page 18 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, 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. 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. The home is maintained to a high standard and is clean and comfortable. Evidence: The home is located near Manor Heath Park in Halifax. The local town centre is approximately 1/2 mile away with all its facilities. There is a car park at the front of the building and seating outside the front door for people to use in nice weather. The new owners are in the process of totally redecorating and refurbishing the home. This has made a remarkable difference. The lounges are bright, comfortable and clean. One has a large screen TV and the other is a quiet lounge with a music system for people to use if they wish. There are single and double bedrooms available and many of these have also been redecorated and totally refurbished to a very high standard. Improvements are ongoing with plans to improve the bathrooms in the near future. Fire precautions in the home have been improved to make sure the home meets the requirements of the fire authority. The laundry is well equipped. People told us that the laundry system is good and that Care Homes for Older People Page 19 of 27 Evidence: their relatives always look well dressed. Care Homes for Older People Page 20 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. 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. There are enough staff on duty to meet peoples needs. Staff are well trained and competent to do their job. Staff are properly checked before they start working in the home to make sure they are suitable and safe to work with older people. Evidence: Staff told us that that there are always enough staff on duty and if someone phones in sick the manager or nurse make sure that there is cover for that person. Recruitment procedures at the home are good. Staff files confirmed that the necessary checks are being completed to ensure the suitability of new staff. This means that staff are safe to work with older people. We asked staff about their induction training when they first started working at the home. One person said I was shown around and told all I neded to know and was made to feel very welcome. I have only just started work at Holly Bank in the last few months but I feel like Ive been here for years. All of the staff and owners are very friendly and caring. We asked staff if they are being offered training. Staff told us that nearly all of the care staff have or are working towards their National Vocational Training (NVQ) awards in Care at either level 2 or 3. This means that staff are well trained and Care Homes for Older People Page 21 of 27 Evidence: competent to do their job. Staff told us that staff meetings are held regularly and that the manager talks to them individually about their work. Staff told us that they feel they have enough experience and knowledge to do their job. They also said that they were always willing to go on more training courses. Care Homes for Older People Page 22 of 27 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. 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. The home is well managed and run in the best interests of the people living there. Evidence: Holly Bank is a family run business. The owners have two other homes in Calderdale. The registered manager is an experience manager of residential care homes. This is the first nursing home that she has managed. She has recently accepted some nurses resignations and has recruited new nursing staff who are due to start soon. One of these will be taking the clinical lead and will be responsible for the delivery of care and the clinical supervision of the nursing staff. People living in the home are consulted about the running of the home at meetings and the annual quality assurance questionnaires. These surveys have been sent out recently. When they are returned the manager will publish the results so that people know what has been said about the home and know what action the manager is going to take to address any issues raised. The registered owner is aware that he must write Care Homes for Older People Page 23 of 27 Evidence: a monthly report about the home and make various checks to make sure that it is being managed properly. Copies of these reports must be available at the home. The manager does not hold money on behalf of people living in the home. People or their relatives are then invoiced for any additional services they receive such as hairdressing and chiropody. There is a written Health and Safety policy. The manager is currently arranging training for all staff in moving and handling, health and safety, fire safety, first aid and infection control training. This will make sure that all staff are up to date with their practice. We looked at a selection of service records for equipment that is in use. We found that these were all up to date. Care Homes for Older People Page 24 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 Older People Page 25 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 1 1 5 Copies of the Service User Guide must be available to give to people. This will make sure people get written information about the service. 01/04/2009 2 3 14 People must be assessed before they are offered a place at the home. This will make sure that the home can meet their needs. 01/04/2009 3 7 15 The new care plans must be implemented. This will make sure peoples needs are met. 01/04/2009 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 12 Staff should make sure that peoples life histories and personal preferences are recorded in their care plans. Page 26 of 27 Care Homes for Older People Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.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 Older People 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!