Inspection on 12/11/08 for Holly Park

This inspection was carried out on 12th November 2008.

CSCI found this care home to be providing an Adequate 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 Park 13/11/07

Holly Park 09/01/07

Holly Park 16/05/06

Holly Park 02/11/05

Holly Park 28/06/05

Holly Park 22/02/05

Holly Park 06/01/05

Holly Park 16/12/04

Holly Park 30/09/04

Holly Park 29/06/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Holly Park Clayton Lane Clayton Bradford BD14 6BB     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Liz Cuddington     Date: 1 2 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Holly Park Clayton Lane Clayton Bradford BD14 6BB 01274883480 01274816120 HollyPark@parkhomesuk.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Park Homes (UK) Ltd Type of registration: Number of places registered: care home 43 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 43 The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, maximum number of places 43 Dementia Code DE, maximum number of places 25 Date of last inspection Brief description of the care home Holly Park was converted from a former school property. It is located in the centre of Clayton village and is conveniently placed for shops, library, church and local bus route. Accommodation is provided on the ground and first floor, predominantly in single bedrooms. The rooms on the first floor and in the reception area have en suite facilities. There is now a passenger lift, providing access to the first floor. There are Care Homes for Older People Page 4 of 28 Over 65 0 43 25 0 Brief description of the care home three separate communal rooms consisting of two lounges and a dining room. Fortythree people can be accommodated and the home is registered for nursing as well as personal care. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is one star. This means the people who use this service experience adequate quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The purpose of this inspection was to assess the quality of the care and support received by the people who live at Holly Park. The visit to the home was carried out Care Homes for Older People Page 6 of 28 over one day by one inspector. The last key inspection was in November 2007. The methods used to gather information included conversations with the people living at the home, their relatives, the staff and healthcare professionals, as well as looking at care plans and examining other records. We received the homes self-assessment questionnaire before the inspection visit. We also received questionnaires from people who live at the home, staff and social care professionals. These gave us a lot of useful information about the home and helped us plan the visit. The fees charged are variable and depend upon the level of the individuals care and support needs. We would like to thank the people who live at the home, their relatives and the staff, for their welcome and hospitality and for taking the time to talk and share their views during the visit. What the care home does well: What has improved since the last inspection? All the requirements we made at the last key inspection have been met. Everyone who lives at Holly Park has now been issued with a contract detailing the terms and conditions of their stay. The medicines administration system has been improved, to make sure that all medication is being administered accurately. Care Homes for Older People Page 8 of 28 The new chef is providing better choices for diabetics and there is a regular kitchen cleaning programme in place. The complaints handling systems have been improved and all complaints are now dealt with quickly and satisfactorily, with good records being kept. The staff have now received training in dementia care, adult protection and infection control, as well as attending other work related training courses. All staff are now starting to have regular one to one supervision with their line manager. The kitchen was clean, tidy and hygienic. A new refrigerator has been purchased and the dishwasher has been repaired. Staff have taken training in the safe use of chemicals. The gas and electrical safety inspections that were not in place at our last visit, have now been completed. A major programme of refurbishment has made the home more attractive and comfortable. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assessed before they are admitted to the home, to make sure their needs can be met. Evidence: People said that they were given enough information about the home before deciding to move in, and they have also received a contract. Where possible the home encourages people and their families to visit the home and talk to the people who already live at the home, their relatives and the staff. The home invites them to come and spend time at the home, share a meal and maybe take part in the days activities. This means that the home can get to know the persons needs and the individual has the information he or she needs to make a decision. The care plans included pre-admission assessments completed by the home. Before Care Homes for Older People Page 11 of 28 Evidence: moving into Holly Park, peoples needs are assessed to make sure that the home is able to meet their needs. This assessment forms the basis for the individual plan of care and support. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal and healthcare needs are met. People are generally protected by the medication administration systems. Staff treat people with respect, care and consideration at all times. Evidence: People receive the medical and healthcare support they need and any concerns about peoples health are followed up. Everyone we spoke to said the care and support provided is of a good standard. Peoples relatives said they are very happy with the care offered. One relative said that the staff do what the person wants in the way they prefer. They said they are very satisfied with the care and support their relative receives and feel that the staff understand the persons needs. One person said they would not want their relative to be anywhere else. Our observations also confirmed that the staff understand peoples Care Homes for Older People Page 13 of 28 Evidence: care needs. Each person has their own keyworker. There is a record file kept in everyones bedroom for staff to complete when certain tasks have been completed and to record any significant observations. We saw one incident of someone being supported when walking, in a way that is not safe. The manager said this would be put right straight away. Three care plans were looked at, to make sure that peoples health and personal care needs are being met in the way each person prefers. The plans cover each area of the individuals care needs. They all contain enough information to guide staff in how to care for and support each person. The care plans are straightforward, well organised and easy to follow and each area of a persons needs is detailed. The plans include risk assessments and management plans where someone is at risk of falling, developing a pressure sore, becoming malnourished or any other area the staff feel may put the individual at any risk. The people themselves, and their relatives if they wish, are involved in reviewing and updating the care plans. The plans are all reviewed regularly by the staff, to make sure they still reflect the individuals care and support needs. People said that staff are very good and understand their needs. They said staff do what people want, in the way people prefer. People said they are happy with the care they receive. Detailed medical records are kept showing, for example, when the GP visited and the outcome, as well as any further healthcare suppport that is needed. The visiting healthcare professionals said that the way the staff look after peoples health care has improved recently and the staff follow their care instructions on most occasions. One social care professional said that peoples healthcare needs are met by the staff. They also said that the staff usually have the necessary skills and experience to support peoples health and social care needs and they treat people as individuals. The medicines are kept safe and secure and the Medicines Administration Record (MAR) charts are securely stored. For security, the medicine cabinet was locked during the time between giving each person their medication. Most of the medicines are supplied by the pharmacy in a monitored dosage system, but some is kept in the Care Homes for Older People Page 14 of 28 Evidence: original packaging. The MAR charts, which must show clearly the quantities of medicines received and in stock for each person, were examined. The medicines supplied in the monitored dosage system appeared to be administered and recorded accurately. There were signatures to confirm that staff had administered the medicine. The records of amounts received, administered and in stock of some medicines that were supplied in their original packaging were accurate. However, a brought forward system would make it easier to check all quantities of medicines, to confirm that administration is always accurate. During the visit, all the staff were seen to treat people with respect and maintain their dignity. The people who commented said that they receive the care they need and are supported to maintain their independence for as long as they are able. Peoples relatives confirmed this. Everyone said the staff listen and act on what they say. Care Homes for Older People Page 15 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to take part in a range of activities. People are offered a good choice of meals to make sure their dietary needs and preferences are met. Evidence: There is now an activities co-ordinator in post and there is a weekly programme of activities which is put up on the notice board. On the day of our visit, there was a quiz in the afternoon. People go out for walks around the local area and also take part in village life. They visit the library and attend exhibitions of local history. The home is having a stall at the Christmas market and people from the nearby sheltered housing flats were invited to the homes Halloween party. This event was also very well attended by peoples relatives. The photographs show everyone enjoying themselves. A group of people and relatives went out to Gargrave recently, visiting a pub and a garden centre. Care Homes for Older People Page 16 of 28 Evidence: Several people said they would like there to be more activities, and others felt there were enough. This is an area the homes staff are developing. Everyone confirmed that people are supported to make their own decisions about all aspects of their life. People said they like the meals and thought they were very good with generous portions. The meals are planned to include the wishes of the people who live at the home and to meet any special dietary needs. Drinks are available throughout the day. At lunchtime there is a choice of main course and dessert and the menus are flexible, to suit peoples preferences. There is always food available for staff to make a snack for people during the night. The new chef said that he discusses the menus with people and makes changes to meet peoples preferences. He tries different dishes to see if people like them and will make sure meals are enriched for people who need it. The chef was knowledgable about peoples different dietary needs and makes sure that special diets are provided for those who need them. People seemed to enjoy their meals and staff were on hand to discreetly assist people who needed some help to eat and to encourage people to finish their meal. The tables were laid with tablecloths, cutlery and napkins. Drinks of juice and tea were provided. Conversations with people confirmed that the staff support people to maintain and meet their cultural needs. People are supported to attend religious services and follow their beliefs within the home, if they wish. Visitors are always welcomed to the home. There is a relaxed atmosphere and a good relationship between people who live at Holly Park and the staff. Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are aware of how to raise a concern or make a complaint if they are dissatisfied with the service. Most staff have received suitable training and understand the adult protection policies and procedures, which makes sure that people at the home are safe. Evidence: Any complaints or concerns are recorded in a complaints file. The actions taken and the outcomes are recorded. Staff said they know what to do if anyone has concerns. The relatives said the home responds appropriately to any concerns and everyone said they know what to do if they have a concern or complaint. Since the last inspection the home has dealt with four complaints. Details of these have been recorded and we were told that improvements have been made as a result of the investigations. Newly employed staff are made aware of the homes whistle blowing policies and procedures, to be used if they suspect abuse or see examples of poor practice. Most of the care staff have had adult protection training, and further refresher training is Care Homes for Older People Page 18 of 28 Evidence: planned. All the appropriate policies and procedures are in place to guide staff. Since our last visit four concerns have been referred to Bradford Social Services Adult Protection team. These have all been investigated and adult protection staff are satisfied with the outcome and the measures taken to improve care practice. The home has developed better links with local healthcare professionals to try and make sure these sorts of issues do not occur again. We were told that the District Nurses were providing additional training for the care and nursing staff. Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a safe, comfortable, attractive and generally well-maintained environment. Evidence: The home is clean and generally well maintained and everyone we spoke to said the home is always kept fresh and clean. The entrance hall is attractive and welcoming, with music playing. The hall, dining room, stairs, upstairs landing and some bedrooms have had new carpets fitted and a new passenger lift has been installed The rooms are comfortably furnished and have a welcoming feel. There are sufficient, accessible toilets and bathrooms on both floors of the house. Staff are employed to help look after the maintenance of the house and grounds as well as keeping the gardens tidy. The home is in the process of replacing the old bedroom furniture with new, more attractive furniture. The gardens are attractive and there is seating for people to use in the better weather. The laundry is as well organised as possible, considering its position in such a small Care Homes for Older People Page 20 of 28 Evidence: and inconvenient outbuilding. The staff make sure that peoples personal clothing, as well as bedding and towels, are properly cared for. Protective gloves and aprons are available for staff to use, as part of their infection control procedures. The laundry floor and walls need treating to make them impermeable, in order to support the homes infection control measures. To support the homes infection control measures, soiled laundry is sluiced and put in separate, dissolvable bags before washing. A new washing machine has been bought which has infection cotrol programmes. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Sufficient staff are employed to meet peoples needs. People are protected by thorough recruitment procedures, which ensure that staff are suitable to work with people who live at the home. Suitable training is provided to make sure staff have the skills and knowledge they require to be able to meet peoples needs. Evidence: The staff rotas, and peoples comments, confirmed our observations that there are enough staff on duty to meet peoples care needs. There has been a high turnover of staff during the last twelve months. Fifteen care and nursing staff have left, which is a high proportion of a total of eighteen staff. This means that the home have had to recruit a lot of new staff. We were assured that this trend has now stopped and the vacant posts have been filled. One visiting professional commented that the staff seem to be more interested in their work than previously. Care Homes for Older People Page 22 of 28 Evidence: All new staff complete an application form and provide two written references. Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) register checks are obtained and no new staff begin work until these checks have been completed satisfactorily. There is plenty of training available for staff. All the staff we spoke to said the training is good and keeps them up to date. The home keeps good records of staff training, which also shows when updates are needed. All new care staff complete induction training which meets the Skills for Care criteria. This gives them good basic training to help them do their job effectively, and provides a sound basis for taking a National Vocational Qualification (NVQ) course. In addition staff attend training courses covering all areas of the general principles of care. The nursing staff have had training updates including medication management, moving and handling and palliative care. Some of the staff are taking training in dementia care through Park Lane College, Leeds. Four of the fourteen care staff have achieved an NVQ in care. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is safe and well managed, in the best interests of the people who live there. Evidence: Since the last inspection visit the manager has left. A new manager had been appointed who was expected to start in post the week after our visit. While the home has been without a registered manager, one of the organisations management team has been running the home. One visiting professional commented that recently the home has been managed better and there are clear signs of improvement. The records, and the staff, confirmed that all staff are now starting to have regular one to one supervision meetings with their line manager. This supports staff to plan their Care Homes for Older People Page 24 of 28 Evidence: personal and professional development and gives them the opportunity to discuss any areas of concern in a confidential setting. Peoples personal information is stored securely. Where the home helps people to manage their personal finances, accurate records are kept of all transactions and all monies are securely stored. The homes policies and procedures are kept up to date, to make sure they provide relevant information to guide staff on how to act in every situation. All the regular health and safety checks for the home are carried out in a timely manner. The fire safety checks are carried out regularly and staff have had the necessary training and fire drill practice. These measures make sure that the health, safety and welfare of the people at the home is promoted and safeguarded. The homes kitchen had an inspection by an Environmental Health Officer before the new chef started in his post. The kitchen was awarded two stars. The chef said he has been working hard to make improvements to bring the kitchen up to a good standard. When we looked, the kitchen was clean, tidy and hygienic. A new refrigerator has been purchased and the dishwasher has been repaired. Staff have taken training in the safe use of chemicals. The gas and electrical safety inspections that were not in place at our last visit, have now been completed. The home has a range of quality assurance systems in place, to help determine the quality of service the home offers. These include surveys for the people who live at the home and their relatives, meetings for people and their relatives, staff meetings and regular audit checks. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 26 The laundry walls and floor should be treated to make them impermeable, in order to help prevent the spread of infection. In order to have a well trained staff team, able to offer good quality care, more care staff need to complete the NVQ award in care. 2 28 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!