Inspection on 23/05/07 for Holly Lodge

This inspection was carried out on 23rd May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 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 Lodge 01/02/06

Holly Lodge 14/06/05

Holly Lodge 07/12/04

Holly Lodge 07/09/04

Holly Lodge 22/03/04

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

CARE HOMES FOR OLDER PEOPLE Holly Lodge Gaskell Road Bucknall Stoke-on-Trent Staffordshire ST2 9DW Lead Inspector Pam Grace Key Unannounced Inspection 23rd May 2007 11:45 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 Lodge DS0000008238.V335429.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 Lodge DS0000008238.V335429.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Holly Lodge Address Gaskell Road Bucknall Stoke-on-Trent Staffordshire ST2 9DW 01782 303952 01782 302187 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) Mrs Shirley Mary Harrison Mr George Littleton Mrs Shirley Mary Harrison Care Home 12 Category(ies) of Dementia - over 65 years of age (4), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (2), Old age, not falling within any other category (12) Holly Lodge DS0000008238.V335429.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st February 2006 Brief Description of the Service: Holly Lodge is a residential care home offering 12 places; four of these may be for service users with mental frailty. At the time of this inspection there was one vacancy. Holly Lodge is a two-storey purpose built establishment; it is situated in a residential area of Bucknall, affording service users the opportunity of maintaining links with the neighbouring community. It is well placed for the local amenities and the home has the facility of a main bus route. Both the exterior and interior of the property are very well maintained, it is exceptionally clean and the décor is set to a very high standard. The service users are offered easy access to all areas of the home by the use of grab rails and a lift. All bedrooms meet the required sizes set out by the national minimum standards and are equipped with suitable fixtures and fittings. The bathrooms and toilets are well located and offer appropriate equipment and facilities. Communal areas are spacious and comfortable; the lounge area has doors opening onto a large conservatory overlooking a mature and well-kept garden. Patio areas with seating are available and easily accessed. Satisfactory car parking is available. Current fees range from £350.00 to £377.00 weekly, and are subject to annual review. Additional charges apply for trips out, newspapers, hairdressing and personal toiletries. The NHS chiropodist visits the home every 12 weeks, this service is free of charge. Holly Lodge DS0000008238.V335429.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Key unannounced inspection was carried out over 5 hours by one inspector. The inspection had been planned with information gathered from the CSCI database, the Pre-Inspection Questionnaire that had been completed by the Deputy Manager, and comments received from residents and relatives. The key National Minimum Standards for Older People were identified for this inspection and the methods in which the information was gained for this report included case tracking, general observations, document reading, speaking with staff, residents and visiting relatives. A tour of the environment was also undertaken. The Registered Care Manager Mrs Shirley Harrison, and the Deputy Manager Ms Fiona Harrison assisted the inspector throughout the inspection. At the end of the inspection, feedback was given to the Care Manager, and Deputy Manager, outlining the overall findings of the inspection. Residents spoken with were very positive about the care they were receiving. There had been no complaints received by CSCI or made to the home, since the last inspection. Feedback returned to the inspector totalled 12`Have Your Say’ documents. No comment cards had been received at the time of this report, from other professionals. Feedback and comments received were generally positive, and included, “all members of Holly Lodge staff are a joy to know”, and “I am more than happy with the love, care and attention that my relative receives”. “The staff can’t do enough for you”. The home continues to exceed the majority of national minimum standards. There were no requirements or recommendations made as a result of this unannounced inspection. What the service does well: Holly Lodge DS0000008238.V335429.R01.S.doc Version 5.2 Page 6 Holly Lodge continues to be highly respected within the community and surrounding areas. The management and all the staff within the home contribute to the high standard of service provided. Their commitment to the provision of a quality service for their residents is commendable. One resident’s comment verified the way residents feel who live there. “ I won’t hear a bad word said about it here.” The management team work in partnership with other professional bodies to ensure the best outcome for the residents. The management are transparent and open and always welcome discussions around continually taking their service forward. The home operates a person centred approach and demonstrates a very good understanding of residents’ care needs. Assessment and care planning are of a high standard; the risk assessments are well managed. The deputy manager is very pro active in supporting staff training, and ensuring that they receive regular, appropriate and supportive supervision. Staff spoken with confirmed that they feel well supported, and their individual needs are identified and met accordingly. There are very good lines of communication between staff and the management of the home. Which in turn ensures that residents’ needs are well met. The home has a safe and robust recruitment policy and procedure. All newly appointed staff undergo an excellent induction programme to promote good practice, confidence and understanding in regard to service delivery. There is a commitment to NVQ training for staff, over 60 of care workers have either achieved the award or are working towards it. The home is exceptionally well presented, with the achievement of a high standard of cleanliness, and regular maintenance. This is a credit to the hard work of the home’s management and staff. Policies and procedures are continually reviewed and updated. Holly Lodge DS0000008238.V335429.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Holly Lodge DS0000008238.V335429.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 Lodge DS0000008238.V335429.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): 1,2,3,4, and 6 - Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Prospective people and their representatives have the information needed to choose a home, which will meet their needs. They have their needs assessed and a contract which clearly tells them about the service they will receive. EVIDENCE: The homes’ statement of purpose and service user guide offers current and prospective service users and significant others the opportunity to make an informed choice about the services provided and whether the home can meet their needs. Information within these documents exceeds the national minimum standards. The Statement of Purpose and Service User Guide were available to the Commission for Social Care Inspection (CSCI), social workers, prospective residents and their families. Holly Lodge DS0000008238.V335429.R01.S.doc Version 5.2 Page 10 An example of the Contract that residents receive was examined. The Contract evidenced that each service user receives an appropriate Contract or Terms and Conditions, following a decision to stay at the home. The previous inspection report is also available to read at the home. The care manager, residents and visiting relatives spoken with stated that prospective residents and their families are welcome to come and visit the home and have a look around before admission. The care manager confirmed that Intermediate Care is not provided at this home. Holly Lodge DS0000008238.V335429.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 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. EVIDENCE: A random sample of 4 care plans was examined. There was written evidence of good local health support, particularly in relation to District Nurse and GP support. Health and Safety Risk assessments were evident and up to date in care plans seen. Pre-admission assessments were clear and formed the basis for the care plan. Appropriate recording of daily tests e.g. diabetic blood sugar was evident. Health needs were addressed. The optician and chiropodist regularly visit the home. Visits from the GP or other health professionals are documented and recorded. In line with case tracking, residents and staff were spoken with. Residents spoken with praised the staff and the manager highly, they said that they only had to mention that they were feeling unwell, and staff always responded to their needs appropriately. Holly Lodge DS0000008238.V335429.R01.S.doc Version 5.2 Page 12 Service users are protected by the home’s policies and procedures for dealing with medicines. Medication is appropriately stored, administered and recorded. The care manager is looking into the purchase of a medication fridge for the correct storage of medicines requiring cooler temperatures. Staff demonstrated a personal empathy with residents through a respectful, yet friendly discourse. All of the residents spoken with felt very happy with the care they were receiving in the home. Feedback and comment cards returned to the inspector totalled 12`Have Your Say’ documents. Feedback and comments received were generally very positive, and included, “all members of Holly Lodge staff are a joy to know”, “ I am more than happy with the love, care and attention that my relative is given”, and “the staff can’t do enough for you”. When asked whether dignity and privacy were upheld at the home all of the residents and relatives spoken with confirmed this and commented that the staff always treated them with respect. Holly Lodge DS0000008238.V335429.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 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who use this service are able to make choices about their life style, and are supported to develop their life skills. Social, educational, cultural and recreational activities meet individual’s expectations. EVIDENCE: Activities within the home were recorded in a daily diary. The home does provide and encourage social activities for residents including sing along music, reminiscence group, armchair exercises, bingo, a small library – with larger print books available. There is a weekly prayer meeting conducted by the local Minister. There are also organised trips out, a quiz and board games. There was evidence from talking to residents and visiting relatives that contact is maintained with family and friends on a regular basis. There were no restrictions placed on visiting times, and the home provides a relaxed and friendly environment. Some residents attend a local social club, and go for walks, or for a pub lunch. The home maintains strong links with the local church and the Minister. Holly Lodge DS0000008238.V335429.R01.S.doc Version 5.2 Page 14 Rooms seen were very well maintained, clean, and furnished to a good standard. Residents were able to bring in small items of furniture and bedrooms were personalised with residents’ possessions. Residents said they had the opportunity and choice to have their hair done. Staff and residents spoken with said that the routines within the home were quite flexible although meals needed to be taken within a time framework. Residents were able to get up when they wanted. Residents were able to spend time in their rooms or in the communal areas if they wished to. The kitchen environment was clean and tidy, with up to date daily records kept in regard to cleaning. Recording of Fridge and freezer temperatures had been appropriately documented and recorded. The verbal feedback from residents in relation to the quality and variety of food served at the home, was that it was of a good standard, and that the 4 weekly rotational menus reflected the wishes of service users, as well as the changes in season. Residents also confirmed that they enjoyed the meals at the home, and that they are always consulted regarding their preferences. Holly Lodge DS0000008238.V335429.R01.S.doc Version 5.2 Page 15 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 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who use this service are able to express their concerns, and have access to a robust, effective complaints procedure, are protected from abuse, and have their rights protected. EVIDENCE: There had been no complaints received by the home or CSCI since the previous inspection. There was a clear and accessible complaints and protection of vulnerable adults procedure in place at the home. The care manager stated that she would take all concerns and complaints seriously. Complaints would be documented and recorded. Residents and relatives spoken with, confirmed that they would know who to approach should they have any concerns or complaints. Staff spoken with confirmed that they were aware of the need to monitor the safety of residents and to protect them from any form of abuse. They were also aware of the home’s Whistle Blowing policy. The inspector discussed with the care manager and the deputy manager, the need for all staff to receive refresher training in relation to the protection of vulnerable adults. This is being planned for the coming year. Holly Lodge DS0000008238.V335429.R01.S.doc Version 5.2 Page 16 The home’s robust recruitment procedure includes appropriate CRB/POVA Police checks prior to staff’s commencement of employment. Holly Lodge DS0000008238.V335429.R01.S.doc Version 5.2 Page 17 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): 19,23,24,25 and 26 - Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enables people who use the service to live in a safe, well-maintained and comfortable environment, which encourages independence. EVIDENCE: All areas of the home were found to be safe, clean and well presented, to a very high standard. The décor of rooms seen was very well maintained, and they were furnished to a good standard. Residents were able to bring in small items of furniture and bedrooms seen were personalised with residents’ possessions. The inspector noted during a tour of the building, that all wardrobes were fixed to the wall for safety. Holly Lodge DS0000008238.V335429.R01.S.doc Version 5.2 Page 18 The laundry and kitchen areas were clean and tidy, with up to date daily records kept in regard to cleaning of the kitchen. Recording of Fridge and freezer temperatures had also been appropriately documented and recorded. The pre-inspection questionnaire completed by the Deputy Manager confirmed that maintenance records were all in order and up to date. The home has an ongoing rolling programme of maintenance and repair. Holly Lodge DS0000008238.V335429.R01.S.doc Version 5.2 Page 19 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): 27,28,29,30 - Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff in the home are trained, skilled, and in sufficient numbers to support the people who use the service, in line with their terms and conditions, and to support the smooth running of the service. EVIDENCE: Staff rotas and recruitment records were examined, and 3 members of staff were interviewed, including one new staff member. Staffing levels were discussed with the care manager in relation to the dependency levels of the residents, and the number of residents living at the home. Rotas showed that existing staffing levels had been maintained. The home prides itself on retention of staff. The pre-inspection questionnaire completed by the care manager, showed that few staff had left the service, and those who had done so, had left for genuine reasons. Discussions with staff were positive, and showed a clear determination that they belong to a committed team. Holly Lodge DS0000008238.V335429.R01.S.doc Version 5.2 Page 20 Staff spoken with and records examined, confirmed that they had undertaken appropriate training, including moving and handling, fire, first aid and infection control. The care manager confirmed that staff undergo appropriate medication training. Dementia training is about to be undertaken by some staff at the home. The deputy manager is totally committed to staff training needs and supervision. Staff spoken with and records seen confirmed that care staff were receiving regular supervision as per the National Minimum Standard. A sample of recruitment files were made available for inspection purposes, from those seen there was evidence that the home’s recruitment practice is robust and satisfactory. Five staff have achieved their level 2 or above in relation to NVQ training. This means that to date 60 of the staff team have achieved this. Regulation states that 50 of the workforce must be trained; Holly Lodge just exceeds this level. The deputy manager provided a staff training schedule to the inspector, with the pre-inspection documentation. Holly Lodge DS0000008238.V335429.R01.S.doc Version 5.2 Page 21 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): 31,33,35,36 and 38 - Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect, has effective quality assurance systems developed by a qualified, competent manager. EVIDENCE: The inspector had received 12 ‘Have your say’ documents, which the CSCI issue to relatives, and or their representatives. There were no comment cards received from other professionals. The general theme of these was that residents and relatives were very happy and satisfied with the service that they and or their relatives receive in the home. Holly Lodge DS0000008238.V335429.R01.S.doc Version 5.2 Page 22 The home’s Statement of Purpose and Service User Guide was made available for the inspector to view. These were of a high standard, which exceeded the National Minimum Standard. Care Plans seen were comprehensive, clear, and up to date. Records show that the health and social care needs of residents are being met. The care manager deputy manager, and staff spoken with, confirmed that they had received regular and appropriate training. The deputy manager provided an up to date training schedule to CSCI. The care manager is very well qualified and experienced to oversee the running of the home. The deputy manager supports the care manager in the daily running of the home, and is committed to the co-ordination of training for staff. The deputy manager achieved the Registered Manager’s Award in 2005. Staff, residents and visiting relatives spoken to were very complimentary about the care manager and deputy, and confirmed that they are always approachable and supportive. The deputy manager confirmed in the Pre-Inspection Questionnaire, that records relating to the testing of fire alarms and emergency lighting were up to date and well documented. Financial issues were not spot checked on this occasion, and will be monitored at the next inspection. However, the care manager confirmed that there is a robust procedure in relation to residents’ monies. Staff spoken with stated that they were receiving formal supervision. Existing staffing levels have been maintained, and staff retention in the home is very good. Accidents are recorded appropriately and as required, and there had been no complaints received by CSCI since the previous inspection. Residents and their relatives are aware of how to make a complaint if they wish to. The complaints procedure is on display in the home. The care manager, deputy manager, staff, and residents spoken with confirmed that resident and staff meetings are being held. There is a quality assurance system in place at the home. This is co-ordinated and managed by the deputy manager. Residents, relatives and/or their representatives are invited to express their views at least twice yearly in a written format. This information is then collated and acted upon. All areas of the home are well maintained, and kept clean, to a high standard. The home has an ongoing rolling programme of maintenance and repair. Holly Lodge DS0000008238.V335429.R01.S.doc Version 5.2 Page 23 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 4 3 3 4 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X 4 4 3 3 STAFFING Standard No Score 27 4 28 4 29 4 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 3 X 3 3 3 4 Holly Lodge DS0000008238.V335429.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action 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 Lodge DS0000008238.V335429.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Stafford Local Office Dyson Court Staffordshire Technology Park Beaconside STAFFORD St18 0ES National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Holly Lodge DS0000008238.V335429.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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