Inspection on 25/05/06 for Holly House

This inspection was carried out on 25th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Holly House 16/05/08

Holly House 19/10/05

Holly House 14/04/05

Holly House 07/12/04

Holly House 12/07/04

Holly House 25/02/04

Similar services:

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Dalewood Respite Care

Orchard,The

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Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Holly House 32 Chapel Street Newport Isle Of Wight PO30 1PZ Lead Inspector Neil Kingman Unannounced Inspection 25 May 2006 09:30 Holly House DS0000012580.V290451.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Holly House DS0000012580.V290451.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Holly House DS0000012580.V290451.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Holly House Address 32 Chapel Street Newport Isle Of Wight PO30 1PZ 00441983 825886 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 G Elliott Mrs Brenda Mary Furse Mrs Brenda Mary Furse Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Holly House DS0000012580.V290451.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19 October 2005 Brief Description of the Service: Holly House is a small home providing care and accommodation for up to three younger adults with a learning disability. The home is a mid-terrace town house situated in a residential area of Newport, the County Town of the Isle of Wight. Resident accommodation within Holly House comprises three single bedrooms, a communal lounge and shared bathroom and kitchen. Being a small care facility the proprietors/manager live in and share many of the homes amenities with the residents. The central location of the home affords residents easy access to the many shops and amenities the town centre has to offer. Transport is also readily accessible with the towns main bus depot a short walk from the home. Holly House DS0000012580.V290451.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report details the results of an evaluation of the quality of the service provided by Holly House and brings together accumulated evidence of activity in the home since the last key inspection on 19 October 2005. Part of the process has been to consult with people who use the service, including the residents’ social services care manager. Included in the inspection was an unannounced site visit to the home by an inspector on 25 May 2006. During the visit the inspector spoke with the manager, toured the building and looked at a selection of records. One of the residents was present and contributed to almost all of the process. The inspector returned to the home on 30 May 2006 to speak with the other resident. Views of the residents and their care manager were very positive. What the service does well: What has improved since the last inspection? What they could do better: The manager has confirmed that she is currently upgrading the residents’ personal plans with them to provide a more person centred approach. It is important that all significant events in residents’ lives are recorded in their plans. Holly House DS0000012580.V290451.R01.S.doc Version 5.2 Page 6 An electrical inspection is required to be carried out by a NICEIC qualified contractor. 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. Holly House DS0000012580.V290451.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Holly House DS0000012580.V290451.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service Holly House provides a service for long-term residents and there have been no new admissions for over eighteen months. Those who live in the home have had their needs assessed and reviewed during that time. EVIDENCE: Both residents have the same social services care manager who was able to confirm that Mrs Furse undertook thorough assessments of both residents’ needs before they moved into the home. As a result their placements at Holly House have proved very successful. Each resident has an individual plan, which covers his or her needs and aspirations. The inspector noted they contained an assessment of their individual needs. In discussions with the residents they both said their moves to Holly House were of their own choosing, having visited the home before making the decision to stay. Holly House DS0000012580.V290451.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service The manager has developed and agreed with each resident a personal plan, based on an assessment of his or her needs and wishes. Having recently been involved in the development of health action plans for residents the manager has recognised that the personal plans could be improved, and is in the process of reviewing them. It is important that all significant events in residents’ lives are recorded in their plans. The home does not place restrictions on the residents who can and do make decisions for themselves. They are encouraged to be as independent as possible and to take sensible risks, which enhance their enjoyment of life. EVIDENCE: At the site visit the inspector looked at the residents’ personal plans and their health action plans. Both were discussed with the individual residents themselves. Holly House DS0000012580.V290451.R01.S.doc Version 5.2 Page 10 The last assessment of this standard identified a problem with residents not being able to fully understand what was written in their plans. In discussions this time it was clear that both had good understanding of why they had personal plans and were very clear that the manager involved them when she updated them with information. However, while both are able to read, they do have limitations in their understanding. The format of the plans was seen as dated with many references to ‘care’ instead of ‘support’, which better describes the needs of these residents. The manager said she recognised this and was in the process of reviewing the plans and producing new ones, which, like residents’ health action plans would be more ‘person centred’ and more easily understood. Both residents said that they were able to make their own decisions about their daily lives and gave examples of the many choices they were able to make, e.g., times of getting up and going to bed, work, entertainment, day services, interests etc. In discussions with the manager and one resident it was clear that progress was being made towards improving the individual’s skills with coinage and numeracy, with attendance at college and a local course. This was obviously a significant event in the resident’s life but no mention of it was made in the personal plan. It is important that events of this nature are recorded, not least to evidence the good support that is being delivered by the home. The inspector noted that personal plans set out guidelines for the management of challenging behaviour and contained appropriate risk assessments. Holly House DS0000012580.V290451.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are encouraged and supported to take part in a range of activities inside and outside the home. Both maintain family links and outside friendships where desired. Routines in the home promote independence for the residents who have unrestricted access around the home. They are offered meals they enjoy, which are varied and healthy. EVIDENCE: Some very positive outcomes for residents were evident. One resident wanted to take up employment. The care manager confirmed that arrangements had been made by the home for him to meet this particular aspiration and the resident himself said he valued the experience, which was quite flexible for him during the week, and at weekends. Holly House DS0000012580.V290451.R01.S.doc Version 5.2 Page 12 The other resident leads a fairly active life with different day services, evening club and college. Both regularly visit family and are supported by staff who make it possible. Both residents had recently returned from a holiday in Spain with the proprietors. From their descriptions it was an experience they clearly enjoyed. Food is very high on the list of enjoyable experiences for residents who were unanimous in their approval of the food provided. The manager sent copies of menus to the Commission with the pre-inspection information. They showed food to be quite varied and nutritious. Both residents said they loved the food; the best, they said, at any of the services they had experienced. Residents do enjoy snacks and sweet things and the home makes every effort to balance service user choice with encouraging a healthy lifestyle. Holly House DS0000012580.V290451.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents at Holly House are generally self-caring with encouragement where needed. No technical aids or adaptations are required. The manager ensures that the residents’ healthcare needs are assessed and enables and supports them to manage their own healthcare checks at appropriate intervals. Both residents take regular medication, which is appropriately stored, administered and recorded. EVIDENCE: Residents have very different needs, skills and abilities, although they are both physically able and largely self-caring. Support tends to take the form of encouragement and advice where appropriate. As described earlier in the report the manager is greatly assisting one resident with an identified problem with managing coinage and numeracy. Both residents came across as being very assertive and well able to voice their opinions about the level of support they needed. Holly House DS0000012580.V290451.R01.S.doc Version 5.2 Page 14 At the time of the site visit both residents were in good health. The manager confirmed, and care records showed, that their health care needs are regularly addressed. They receive checks from the GP, dentist, optician and specialist health care professionals. All health care needs of the residents are identified in their personal plans. In discussions with the residents it was noted that one prefers to attend healthcare checks unaccompanied and the other prefers to go with a member of staff. Either way, support and advice is always on hand. One resident self medicates but only for an inhaler. For all other medication both are happy for the home to manage the process. The inspector noted that the arrangements for storage, administration and recording of medication were appropriate. Holly House DS0000012580.V290451.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The culture of the home is open, friendly and supportive. Residents understand that they can go to the manager, staff or their care manager with any complaints or concerns. The home ensures the residents are safeguarded from abuse with a clear adult protection policy and the knowledge to implement it where appropriate. EVIDENCE: While the home has a formal complaints policy and procedure the inspector focused on whether or not the residents knew how to complain if they had any concerns about the service. The residents’ care manager had no doubt that both were well able to voice their concerns either to her or to the home’s management. Both residents said they knew how and who to complain to if they needed. The inspector noted that relations between the residents and the manager were open, friendly and genuine. Both residents were more than happy to discuss issues in front of the manager. The pre-inspection information sent to the Commission confirmed that an adult protection policy and procedure was in place. The inspector saw a copy of the social services policy guidance during the site visit to the home. Holly House DS0000012580.V290451.R01.S.doc Version 5.2 Page 16 Prompt reporting of an incident since the last inspection shows that the home follows adult protection procedures. Holly House DS0000012580.V290451.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 - Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Holly House is a small terraced house like others in the street. It provides a reasonable standard of accommodation, which meets the needs of the people who live there. All areas of the home are generally clean, hygienic and free from unpleasant odours. EVIDENCE: The home provides an individual room for each resident and a communal lounge for their use. The proprietors have their own private accommodation in another part of the building. It is essentially a small domestic environment where the kitchen and bathroom facilities are shared. The residents were happy to show the inspector their rooms, which were reasonably decorated and well personalised. Their lounge was in need of redecoration, but the manager recognised this and said it was due to be done as part of the home’s redecoration programme. At the time of the site visit the builders were replacing the roof, and the inspector took this into consideration Holly House DS0000012580.V290451.R01.S.doc Version 5.2 Page 18 when assessing the state of the accommodation. The manager said there were plans to redecorate the front of the building while the builders’ scaffolding was still in place. All areas of the building were free from unpleasant odours and excepting the builders’ dust were reasonably clean. Both residents said they were very happy with the accommodation and valued its close proximity to the Newport shops and amenities. Holly House DS0000012580.V290451.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Holly House is a family run home employing one additional experienced care support worker who has worked there on a part-time basis for the past four years. With only two residents it has not been necessary to recruit any new staff. EVIDENCE: Holly House has operated as a small registered care home for many years with no more than three residents. In the last year one resident has moved on and not been replaced. The manager has the necessary statutory training qualifications and has enrolled on a college course to achieve the Registered Manager’s Award. Qualification certificates were available for inspection. For the past four years the home has employed the same part-time care support worker who was not on duty on the day of the site visit. Previous inspections have identified the fact that this member of staff works for another care service on a more permanent basis and has undertaken a range of training, which has assured her competency to work with the two residents. Holly House DS0000012580.V290451.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run by experienced people. There are adequate quality assurance measures in place to ensure the home continues to meet its aims and objectives. The manager ensures the health and safety of the residents as far as is reasonably practicable EVIDENCE: The proprietor and manager are very experienced, having provided a service for people with learning disabilities for many years. The manager has enrolled on the Registered Manager’s Award (RMA) course and has completed the necessary statutory training appropriate to the service. Holly House DS0000012580.V290451.R01.S.doc Version 5.2 Page 21 The home is small and domestic in nature with only two long-term residents. Consequently satisfaction surveys, anonymous or otherwise are not carried out. The proprietors rely on residents’ views being expressed in individual and group discussions, care management reviews and CSCI inspections. In conversations with the residents and their care manager it was very clear that any dissatisfaction with the service would be taken up directly with the manager. If they were unhappy residents would speak with their care manager. Both residents confirmed their satisfaction with the service. The pre-inspection information signed by the proprietor and sent to the Commission gave details of the policies and procedures in place. During the course of the site visit the inspector looked at public liability insurance, records of residents’ monies, residents’ individual risk assessments and the gas central heating certificate, all of which were in order. An electrical inspection is required to be carried out by a NICEIC qualified contractor. Holly House DS0000012580.V290451.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 x 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 2 x Holly House DS0000012580.V290451.R01.S.doc Version 5.2 Page 23 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 2 Standard YA6 YA42 Regulation 15 23 Requirement To ensure that all significant events in residents’ lives are recorded in their personal plans. To make arrangements for an electrical inspection by an NICEIC qualified electrician Timescale for action 31/08/06 31/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Holly House DS0000012580.V290451.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Southampton, Portsmouth and Isle of Wight Ground Floor Mill Court Furrlongs Newport, IOW PO30 2AA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Holly House DS0000012580.V290451.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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. 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