Inspection on 17/03/08 for Holly Grange Residential Home

This inspection was carried out on 17th March 2008.

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 Grange Residential Home 27/03/07

Holly Grange Residential Home 11/05/06

Holly Grange Residential Home 19/10/05

Holly Grange Residential Home 10/05/05

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Holly Grange Residential Home Cold Ash Hill Cold Ash Thatcham Berkshire RG18 9PT Lead Inspector Helen Dickens Unannounced Inspection 17th March 2008 10:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Holly Grange Residential Home DS0000062526.V359364.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Holly Grange Residential Home DS0000062526.V359364.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Holly Grange Residential Home Address Cold Ash Hill Cold Ash Thatcham Berkshire RG18 9PT 01635 864646 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) Mr Sundith Ramdany Mrs Koomari Nanda Ramdany Mr Sundith Ramdany Care Home 19 Category(ies) of Old age, not falling within any other category registration, with number (19) of places Holly Grange Residential Home DS0000062526.V359364.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th March 2007 Brief Description of the Service: Holly Grange provides accommodation and care for up to nineteen service users over the sixty-five years, who have care needs associated with old age. The home is currently not registered to provide care to people who have care needs associated with dementia or require nursing care. Due to the number of twin bedrooms, the homes occupancy does not exceed fifteen service users accommodated in single bedrooms, unless a specific request is made to share. The current scale of charges as at March 2008 is between £495.00 and £540.00 per week. There are additional charges for toiletries, hairdressing, newspapers, chiropody and transport for outings. Holly Grange Residential Home DS0000062526.V359364.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This key inspection was unannounced and took place over 7 hours. The inspection was carried out by Mrs. Helen Dickens, Regulation Inspector. The provider/manager, Mr. Sundith Ramdany (Sandy), and the deputy manager, represented the establishment. A partial tour of the premises took place and a number of files and documents, including resident’s assessments and care plans, staff recruitment files, quality assurance information, and the annual quality assurance assessment (AQAA) were examined as part of the inspection process. A number of questionnaires were sent out to residents and health and social care professionals, and 11 were returned following the inspection. The inspector was accompanied by a colleague from the Experts by Experience initiative, whereby someone with personal experience of the care system takes part in the inspection and speaks with residents and staff on some pre-determined subjects. In this case the Expert by Experience was asked to discuss resident’s satisfaction in relation to their care, activities, and mealtimes. The Expert by Experience spoke with twelve residents, and these findings are incorporated into this report. The inspector would like to thank the residents, staff and the provider/manager for their time, assistance and hospitality. Thanks also to the colleague from the Experts by Experience initiative who assisted at this inspection. What the service does well: Holly Grange offers a homely environment which is well furnished and comfortable for residents. There have been a number of decorative improvements (listed below) and the provider/manager works hard to ensure residents live in a pleasant environment. The garden is well kept and on the day of this unannounced inspection the house looked particularly attractive with spring flowers in pots all around the front of the building. Residents were happy at the home and commented favourably on the staff team. Surveys returned to CSCI following the inspection described the home as ‘Having a caring approach to residents’, and ‘Caring for individuals as individuals’. A health care professional who has contact with the home noted ‘Staff are involved and motivated.’ Staff are well qualified with all but the newest staff member being qualified to at least NVQ Level 2. The manager Holly Grange Residential Home DS0000062526.V359364.R01.S.doc Version 5.2 Page 6 came in for particular praise from residents who told the Expert by Experience that he was quick to deal with any problems they had. The manager was commended for the excellent arrangements in place for recording and dealing with any complaints at this home. With regard to equal opportunities, the home has made a number of changes to ensure improved accessibility for residents, for example there are raised toilet seats, rails and ramps, and there are three assisted bath/shower rooms. The home has considered the religious and faith needs of residents and has a good relationship with one local faith group who visits the home on a monthly basis. What has improved since the last inspection? What they could do better: Two Requirements have been made as a result of this inspection. The home must review recruitment arrangements to ensure the information in Schedule 2 of the Care Homes Regulations 2001 (as amended) is on file for each staff member. The manager must also review current arrangements for monitoring health and safety within the home to ensure any shortfalls are identified and dealt with in a timely fashion. Holly Grange Residential Home DS0000062526.V359364.R01.S.doc Version 5.2 Page 7 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 Grange Residential Home DS0000062526.V359364.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Holly Grange Residential Home DS0000062526.V359364.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Resident’s needs are assessed prior to them moving into this home but they would benefit by more information being recorded especially in relation to their nutritional and social needs. EVIDENCE: Three resident’s files were sampled including their initial assessments which were made prior to and in the early days of moving into the home. The format is for a basic outline of each resident’s needs including a dependency risk assessment and a nutritional risk assessment. A ‘pen sketch’ of each resident contains more details about their needs, what time they prefer to get up and go to bed, and their likes and dislikes etc. It was noted that one resident who had been at the home for many years had had their ‘pen picture’ revised and brought up to date as their likes and dislikes had changed. Holly Grange Residential Home DS0000062526.V359364.R01.S.doc Version 5.2 Page 10 The format of the assessment was discussed with the manager as improvements could be made – particularly on the nutritional risk assessments. One dependency risk assessment had not been given an overall score or been signed or dated by the assessor – the manager remedied this straight away. More information regarding resident’s social interests and past hobbies would also benefit residents, and enable staff to meet these needs more fully. Holly Grange Residential Home DS0000062526.V359364.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Resident’s benefit by having their health and personal care needs set out in an individual plan of care and are protected by the home’s policies and procedures for the administration of medication. Residents are treated respectfully at this home. EVIDENCE: Three resident’s files were sampled and all found to contain an up-to-date care plan. These plans are clearly set out and reviewed on a monthly basis. Changes are made as necessary, for example one resident had had their ‘pen sketch’ regarding their preferences in relation to activities of daily living revised. Most residents were spoken with by the Expert by Experience who assisted at this inspection. She reported that on the whole residents were satisfied with the care given to them by the staff, and she received comments such as ‘Staff are polite’ and ‘Staff couldn’t be nicer.’ She observed that staff communicated well with residents who were well looked after. Holly Grange Residential Home DS0000062526.V359364.R01.S.doc Version 5.2 Page 12 The inspector discussed care plans with the manager as there was some room for improvement regarding how residents would like their support to be delivered, and the manager and deputy were keen to address this. A few negative comments received from residents via the Expert by Experience were passed on to the manager for further action. Resident’s files showed records of visits by healthcare professionals including GPs and community nurses. Specialist healthcare workers visited from time to time and this was also clearly recorded. The manager of this home is also a registered nurse and is therefore knowledgeable on resident’s health needs and how to access healthcare services. He has arranged weekly visits to the home by someone who supports residents to do exercises to music and other gentle physical activities, as well as more mentally stimulating activities such as quizzes and bingo. The nutritional risk assessments are now going to be reviewed following discussions during the inspection. The Expert by Experience who assisted with this inspection managed to speak with 12 residents and said there were no negative comments made in regard to their privacy and dignity. Staff were observed to knock on bedroom doors before entering, and all bedroom doors have now been fitted with locks so residents can choose to keep them locked if they prefer. One health care professional who responded to the CSCI survey said, in answer to the question ‘What do you feel the service does well?’ replied ‘treats residents with kindness and consideration.’ Personal care was delivered in private and staff were careful to close toilet and bathroom doors when assisting residents. Staff were heard to speak to residents in a respectful manner and several residents told the Expert by Experience that if they had any problems then they spoke with ‘Sandy’ the manager, who always sorted things out. Holly Grange Residential Home DS0000062526.V359364.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 People who use the service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents would benefit by more work being done regarding their social activities and interests. Contact with family and friends is encouraged and residents are assisted to exercise some choice and control over their lives. Menus are currently being reviewed at this home and this will benefit residents, some of whom expressed mixed views about mealtimes. EVIDENCE: The home has a regular weekly activity provided by a visiting activities worker on one morning per week, and some other ad hoc activities such as hand massage and games like scrabble which are carried out with care staff. The manager said they also have the occasional outside entertainer, for example in a few weeks there will be a 100th birthday celebration. Assessments and care plans have a place to record what activities residents have enjoyed or currently join in with but these records were incomplete. One resident’s plan said he needed a daily structured programme of activities, but there was no evidence this was happening. Another recorded a resident’s interests as only as ‘Likes watching TV.’ The inspector discussed the need to do more work in regard to activities, and in particular to consult residents about their Holly Grange Residential Home DS0000062526.V359364.R01.S.doc Version 5.2 Page 14 preferences, and to advertise events weekly in advance so that residents know what is on. Family and friends are encouraged to visit Holly Grange and residents can see their visitors in private if they wish. Staff spoken with, and in particular the manager, were knowledgeable on resident’s family links. As already mentioned above, the residents have some contact with the local community in that they use local health services, have visits from the local church, and some are taken out by their relatives. One relative who helped a resident complete a survey for CSCI said it would be nice to have a family or visitors room – they thought this would be useful if someone had a few visitors turn up at the same time. They also said it would be nice to have the weekly menu on the board so that if their relative could not remember what they had had for lunch, it would be on the board for their visitor to see. Residents are given opportunities to exercise some choice and control over their lives, for example choosing which clothes to wear, and what meals they would like. Residents meetings and annual questionnaires also give residents the opportunity to have their say. All four residents who returned surveys to CSCI said that staff listened to them and that they knew who to complain to if they had any concerns. On the day of this visit the Expert by Experience who was assisting with the inspection had lunch with residents and sought their views on a number of issues, including meals. She reported that on the whole residents were satisfied with their meals and enjoyed their food. On the day of the inspection there was a home-made minced beef pie with creamed potatoes, broad beans and cauliflower. This was nicely cooked and attractively served to residents. The sweet was tinned peaches and custard. The cook said most of the food was home made, for example the previous day there had been a roast pork lunch. There are alternatives on the menu each day and the cook speaks to each resident in the morning to ask what they would like. Three people require a special liquidised meal. The dining room is in one of the two conservatories and was set out to provide a pleasant dining experience for residents. However, there were a few less favourable comments on meals received both during the inspection, and on surveys returned to CSCI. Out of the four surveys returned from residents, only one said they always liked the food and had no reason to complain. Three others said they ‘usually’ liked the meals, and one added that there was not much choice, if any. On the day of the inspection one resident said the food was a bit bland, and another said there was no flavour in it and they had been given sausages three times in one week. The manager has already recognised there are issues relating to the current menus and has recently revised them. He will be introducing an alternative to the sandwiches which residents currently get for tea each day. Though several residents commented that they liked the assorted sandwiches, there is at present no other alternative. The manager said he plans to Holly Grange Residential Home DS0000062526.V359364.R01.S.doc Version 5.2 Page 15 introduce options such as quiche or scrambled egg for tea in the near future. The manager was also asked to review how liquidised meals were being served to residents. Comments relating to how well catering and care staff interact and support each other and residents regarding food and mealtimes was discussed with the manager following some issues raised during the inspection. It was also noted that whilst the previous requirement to employ sufficient catering staff had been met in relation to the lunchtime period, care staff were still assisting with preparation and serving the evening meal for residents. This will need to be kept under review especially if cooked options are to be introduced in the near future at teatime. Holly Grange Residential Home DS0000062526.V359364.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit by having clear arrangements in place for raising concerns, and they know any such concerns will be taken seriously. Residents are protected from abuse. EVIDENCE: There is a complaints procedure in place at Holly Grange and it is displayed prominently in the hallway. All residents spoken with, and all four who returned surveys to CSCI, said they knew how to make a complaint. Several residents told the Expert by Experience that if they had a problem, ‘Sandy’ the manager would sort it out. The manager should be commended for the very transparent way he records and deals with complaints. There have been six complaints to the manager since the last inspection including staff reluctant to wake someone up for their early morning tea, and someone had felt cold during the night. Even these relatively minor complaints were taken seriously, properly recorded, and appropriated action taken. No complaints have been received about this home to CSCI since the last inspection. The home has a copy of the West Berkshire protection of vulnerable adults policy, and their own in-house version. The manager has been on the West Berkshire training course and a copy of the in-house training pack used to train Holly Grange Residential Home DS0000062526.V359364.R01.S.doc Version 5.2 Page 17 the other staff is on file. There have been no safeguarding vulnerable adults issues raised in relation to this home since the last inspection. Holly Grange Residential Home DS0000062526.V359364.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Holly Grange offers a homely and comfortable environment for residents, which is clean and hygienic throughout. EVIDENCE: Holly Grange provides a homely and comfortable environment for residents, with spacious lounge and dining area, and well-kept gardens. The front of the home looked particularly attractive, as there were many pots with spring flowers in full bloom across the front of the property. There have been good attempts to improve safety and access for residents; inside the building there are ramps and grabs rails and three assisted bathrooms, and outside in the garden there are ramps and rails. The manager said an occupational therapist has assessed the premises since the previous inspection. Communal areas are well furnished in a homely way and a number of improvements have been Holly Grange Residential Home DS0000062526.V359364.R01.S.doc Version 5.2 Page 19 carried out since the previous inspection including decorating the stairs and hallway, purchasing a new over bath hoist and a new commercial washing machine, and up-grading the fire doors. The home has also purchased a new flat screen TV for the enjoyment of residents who use the main lounge. The manager said a small leak on the stairwell means this area will need redecorating once the leak, which has already been repaired, dries out. It was also brought to the attention of the Expert by Experience that not all residents were able to access the garden. This was highlighted to the manager following the inspection. There are good hand-washing facilities at this home with paper towels and individually dispensed soap throughout - the manager removed a cotton towel in a communal area straight away. Laundry facilities are spacious and hygienic and the home has a commercial washing machine and tumble drier. The last environmental health officers visit observed there were ‘good practices’ at this home and they were awarded a certificate for ‘very good’ food hygiene. Issues about access and safety are discussed further under health and safety at Standard 38 below. Holly Grange Residential Home DS0000062526.V359364.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Resident’s needs are met by the numbers and skill mix of staff and the majority of the staff at this home hold qualifications in care. Recruitment arrangements need to be reviewed to fully protect residents. Staff at this home are offered and take up training opportunities so that they are competent to do their jobs. EVIDENCE: On the day of the inspection there were sufficient numbers of staff to meet resident’s needs. This home does well on the ratio of qualified to unqualified staff – but the manager was reminded that staff providing personal care must be at least 18 years old. The manager said that following the last inspection, a cook had been employed from 8-1pm which means care staff are not involved in cooking the main meal, though they do still prepare and serve the evening sandwiches – the cook said she does not currently prepare anything for the evening meal. The manager has reviewed the staff rotas and the menus and so further changes are expected. It is recommended that the manager keep this under review to ensure there are sufficient catering and domestic staff employed at Holly Grange. Holly Grange Residential Home DS0000062526.V359364.R01.S.doc Version 5.2 Page 21 As mentioned above, staff at this home are well qualified – at the previous inspection 100 of staff were qualified to NVQ Level 2 or above - the National Minimum Standards recommends that at least 50 of care staff should hold this qualification. Since then one new member of staff has joined the team and will be signing up to start their NVQ Level 2 qualification. Recruitment records at this home were well kept with Criminal Records Bureau checks completed, and staff are checked against the POVA List, to ensure they have not previously been deemed as unsuitable to work with vulnerable people. Induction, training and supervision records were on the 2 files sampled. However, one file had a gap in employment history with no evidence this had been explored; and someone who had previously worked in a care setting did not have a reference from that previous employer as set down in the Regulations. The manager was also reminded that it is not good practice to get character references from friends, unless those friends happen to be of some standing in the community, for example a doctor or faith leader. There are good training arrangements in place in this home and the manager has identified where there are any remedial actions needed, for example when refresher training is due. Files checked showed staff had had induction training which had been signed off by the manager. The manager has been looking into the Skills for Care Common Induction Standards and is planning on introducing these for all new staff. Holly Grange Residential Home DS0000062526.V359364.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit by living in a well-run home where their views are sought and taken into account. Their financial interests are protected by the home’s policies and procedures. Arrangements for maintaining a safe environment are well developed but further work is needed to fully protect residents. EVIDENCE: The home is run by an experienced and well-qualified provider/manager who is a registered general nurse and a registered mental health nurse; he also has an NVQ Level 4 in management. He is rostered to work full time in the home. Residents said that they feel that the home is well managed and the provider/manager is approachable and kind. They told the Expert by Experience that if they had any problems, he would sort it out and it has Holly Grange Residential Home DS0000062526.V359364.R01.S.doc Version 5.2 Page 23 already been noted under Standard 16 that this home has a very thorough and transparent way of recording and dealing with any concerns or complaints. There is a quality assurance policy in place and an annual development plan at this home. The manager carries out an annual survey as well as ad hoc surveys to gain residents views on their care and the facilities at this home. The 2007/08 plan covered refurbishment, staff training, and improvements to care plan reviews. It was noted during the inspection that care plan reviews were carried out very regularly and properly recorded and signed off by those doing the reviews. There are also resident’s meetings, and the co-owner makes a monthly visit to the home, carrying out a monitoring visit which is similar in format to a Regulation 26 visit. This home also has their quality of service monitored by West Berkshire Council who award them a star rating for their service; Holly Grange is currently rated a 2-star (good) service by the Council. The home keeps a folder containing ‘thank you’ letters and compliments received from relatives, and this was sampled during the inspection. One relative, following the death of a resident, had written: ‘Your kindness, love and patience were certainly appreciated.’ The manager said that the home’s policy is that they do not get involved in resident’s finances. Most residents keep small amounts of money of their own, and all bedrooms have now been fitted with locks should residents wish to keep them locked. Any costs on top of the fees for the home such as hairdressing and chiropody, can be paid for by the manager, who then bills the relatives of each resident directly. There are some good systems in place for managing health and safety at this home including staff training, for example on fire safety and first aid, and a monthly health and safety audit is carried out. The manager said annual checks are carried out for legionella safety, and there are a variety of risk assessments in place for example in relation to hazardous cleaning substances, and the laundry. There are specific risk assessments on each residents file including moving and handling, and nutrition. However, there were a number of shortfalls on the day of the inspection which should have been identified by the home’s own safety checks. These included a cabinet with creams and lotions which was unlocked; a cabinet containing cleaning fluids which had a broken lock, and the laundry area which could have been accessed by residents; there were no locked doors between the hallway in the home and the covered outhouse which connects the laundry to the main building. A large box of washing powder was open and accessible in the laundry room. In addition, two upstairs window restrictors had been removed to air resident’s rooms – the manager was asked to ensure the safety of residents when rooms are being aired, and to make sure a risk assessment is carried out on this matter. A Requirement is being made that the manager Holly Grange Residential Home DS0000062526.V359364.R01.S.doc Version 5.2 Page 24 review current monitoring of health and safety in the home, reminding all staff of their responsibilities in this regard. Holly Grange Residential Home DS0000062526.V359364.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Holly Grange Residential Home DS0000062526.V359364.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP29 Regulation 19 Schedule 2 Requirement Arrangements for staff recruitment must be reviewed to ensure that all staff files contain the information set out in Schedule 2 of the Care Homes Regulations 2001 (as amended) including a full employment history and a reference from their previous employment with vulnerable people. Arrangements for monitoring health and safety within the home must be reviewed to ensure any shortfalls are identified and dealt with in a timely fashion. Timescale for action 17/04/08 2. OP38 13(4)(a) (b)(c) 17/04/08 Holly Grange Residential Home DS0000062526.V359364.R01.S.doc Version 5.2 Page 27 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. 2. 3. Refer to Standard OP3 OP7 OP9 Good Practice Recommendations The assessment format should be reviewed to ensure all aspects of residents needs, including nutrition and social interests and activities are fully recorded. Resident’s would benefit by having more detailed information on how they would like their support to be delivered by care staff. Written guidance should be available for staff regarding the administration of ‘as required’ medication, and there should be an up-to-date list of specimen signatures of those staff currently trained to administer medication. The inspector discussed the need to do more work in regard to stimulating social activities, and asked the manager to consult residents about their preferences, and to advertise events weekly in advance so that residents know what is on. Arrangements for meals and mealtimes should be kept under review to ensure there is a varied and appealing choice on the menu, and that there are sufficient staff on duty, including at teatime, to ensure residents needs are met. 4. OP12 5. OP15 Holly Grange Residential Home DS0000062526.V359364.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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. 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