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Inspection on 01/12/05 for Holly Tree Lodge Care Home

Also see our care home review for Holly Tree Lodge Care Home for more information

This inspection was carried out on 1st December 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

People living in this home are well cared for by a well managed, educated, committed and competent care team. Those residents and one visitor who were spoken too expressed satisfaction with the care and service provided by the home. More than one resident commented, "it`s nice here" and "the staff are kind". All residents are assessed before entering the home and there is a recreational and activity programme provided which provides stimulation. There is a thorough assessment and review of care with wherever possible resident and relative/family involvement. There is a comprehensive programme of education provided which ensures that staff know how to care and support people living in the home. People living in the home live in clean, well decorated, attractive accommodation.

What has improved since the last inspection?

A new hoist has been purchased to enable staff to transfer residents safely. One bedroom has had a new carpet laid and 2 bedrooms have been redecorated. A new carpet has been laid in one of the lounges. A new car park extension has been provided at the front of the home as well as a new accessible garden area. New crockery and new curtains for the dining room have been provided.

What the care home could do better:

The manager should provide clinical procedures for the home.

CARE HOMES FOR OLDER PEOPLE Holly Tree Lodge Care Home 3 Eastgate Scotton Gainsborough Lincs DN21 3QR Lead Inspector Mr Toby Payne Unannounced Inspection 1st December 2005 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Holly Tree Lodge Care Home DS0000034136.V266490.R01.S.doc Version 5.0 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 Tree Lodge Care Home DS0000034136.V266490.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Holly Tree Lodge Care Home Address 3 Eastgate Scotton Gainsborough Lincs DN21 3QR 01724 762537 01724 764469 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) Staywood Limited Mrs Pamela Ellen Timmins Care Home 40 Category(ies) of Dementia (17), Dementia - over 65 years of age registration, with number (17), Learning disability (1), Old age, not falling of places within any other category (22) Holly Tree Lodge Care Home DS0000034136.V266490.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service Users in Category DE must be aged 50 years and over. The bed in Category LD is for a service user as named in the Notice of Proposal to Register dated 21 October 2004. 27th June 2005 Date of last inspection Brief Description of the Service: Holly Tree Lodge provides nursing and personal care for up to 40 people, 17 of whom who have dementia requiring nursing care and are accommodated in a new purpose built unit. On the day of the inspection there were 34 people living in the home. The purpose built, single storey unit for people with mental illness of old age provides accommodation for 17 people in 15 single bedrooms and one double room. All bedrooms are en-suite with 2 having showers. This unit also has one lounge and one dining room. There is a garden area leading off from the lounge. Accommodation in the main building is on two floors and provides 4 double bedrooms and 15 single bedrooms, none of which have en-suite facilities. Accommodation on the first floor is served by a shaft lift. There are 2 lounges and a dining room. The home is also set in its own grounds. Twenty two people aged 65 years and over who require nursing care or personal care and one person aged 55 years who has a learning disability are accommodated in the main building. There are car parking spaces at the front of the home. The service user’s guide states that the aim of the home is “to provide residents with a friendly and supportive environment from which to enjoy an active, full and enjoyable lifestyle”. Holly Tree Lodge Care Home DS0000034136.V266490.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and started at 08.15a.m. It took place over 3½ hours. The inspector spoke to 7 residents, 3 staff, one visitor, one community nurse, as well as the deputy manager and the manager. The main method was called “case tracking”. This involved selecting one resident and tracking the care they received through the checking of their records, discussion with them, the care staff and observation of the care they were receiving. The inspector also observed how care was given to other residents in the home. What the service does well: What has improved since the last inspection? A new hoist has been purchased to enable staff to transfer residents safely. One bedroom has had a new carpet laid and 2 bedrooms have been redecorated. A new carpet has been laid in one of the lounges. A new car park extension has been provided at the front of the home as well as a new accessible garden area. New crockery and new curtains for the dining room have been provided. Holly Tree Lodge Care Home DS0000034136.V266490.R01.S.doc Version 5.0 Page 6 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. Holly Tree Lodge Care Home DS0000034136.V266490.R01.S.doc Version 5.0 Page 7 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 Tree Lodge Care Home DS0000034136.V266490.R01.S.doc Version 5.0 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 4, 5 and 6 Residents receive information to enable them to make a choice as to whether or not they wish to come to this home. Holly Tree Lodge Care Home meets the needs of residents coming into the home. EVIDENCE: All residents are assessed before entering the home and written confirmation is sent to them that the home is able to meet their needs. There is a detailed statement of purpose and service user’s guide and a copy of the service user’s guide is given to each person when being admitted to the home. There is a detailed admission procedure, which identifies the needs of residents coming into the home Residents can have a trial visit lasting up to 8 weeks to see whether or not they like the home. Intermediate care is not provided in this home. Holly Tree Lodge Care Home DS0000034136.V266490.R01.S.doc Version 5.0 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 7, 8 and 11 There is good care planning in this home. The health, personal and welfare needs of the people living in his home are fully met. Staff respect the privacy and dignity. EVIDENCE: All residents had detailed care plans, which described their health and welfare needs. Care records included admission details, assessment of daily living activities, personal history and moving handling assessment, risk assessment, care plan and daily report. Efforts have been made to include residents wherever possible in identifying their care needs and being involved in reviews of their care. There was evidence to show that care plans were up to date and reviewed. There were also clear directions concerning the administration of medication. Registered Nurses are responsible for the administration of medication. Staff receive training on how to care and support those residents who are dying and to their relatives. The home also has a detailed policy concerning death and bereavement, which gives guidance to staff. Holly Tree Lodge Care Home DS0000034136.V266490.R01.S.doc Version 5.0 Page 10 A visiting community nurse commented “I find the staff helpful and courteous whenever I visit and there is a good professional relationship between our service and the home”. Holly Tree Lodge Care Home DS0000034136.V266490.R01.S.doc Version 5.0 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 and 15 The home provides a wide range of social activities. Visitors are made welcome when visiting the home. Residents receive nutritious varied and wholesome food. EVIDENCE: The home has an activities programme and a Christmas programme was being produced. The inspection took place during breakfast and residents were seen to have breakfast at their own pace, with the cook asking them what they wished to have. Breakfast included porridge, wholemeal toast and egg on toast. This was served in the dining room, the lounge or in their bedroom. Breakfast was leisurely and served from 07 00 to 11.00 hours. Residents commented, “the food is very good and well served”. The home has again been awarded a Food Safety Award on the 30/11/2005. A visitor commented, “I can visit whenever I wish to do so and always received a warm welcome” and “I have confidence in the staff and manager”. Holly Tree Lodge Care Home DS0000034136.V266490.R01.S.doc Version 5.0 Page 12 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 and 18 The home takes the issue of addressing complaints and ensuring that residents are safe very seriously and has a comprehensive complaints and adult protection procedure. Resident’s legal rights are protected. EVIDENCE: Each resident receives a detailed complaints procedure when they are admitted to the home. No complaints have been received by the CSCI and home since the last inspection. None of the residents had any complaints about the home and felt they could discuss any concerns with staff or the manager. Staff also knew what to do if they received a complaint from a resident. All staff receive adult protection training and staff knew what to do if adult abuse was suspected. Holly Tree Lodge Care Home DS0000034136.V266490.R01.S.doc Version 5.0 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 23 and 26 The home is well maintained, clean and attractively decorated. Furnishings are of a high standard and any maintenance required is attended to swiftly. Residents are also safe. EVIDENCE: Residents are encouraged to bring into the home small items of furniture, television, pictures and personal mementoes. Locks are fitted to all doors. The home employs separate staff for domestic and laundry services. Gloves and aprons are available and the home has an infection control policy. The home was clean and odour free throughout. The home has a planned repairs and maintenance programme for each month. Residents said how satisfied they were with the decoration and cleanliness of the home. They all spoke of how much they liked their bedrooms. Comments were “I am very comfortable” and “I like my room”. Holly Tree Lodge Care Home DS0000034136.V266490.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 28 There is a well trained and competent staff team. The numbers of staff are sufficient for the numbers of residents. Staff are correctly recruited and there is a very well established team. EVIDENCE: There is an extensive training programme for staff, which includes training in care (NVQ), internal lectures and training from outside trainers. Training included dementia awareness. Staff said how the training provided had enabled them to improve the care and support for the residents. There are also nurses who have responsibility for tissue viability and continence. Residents did not express any worries about the level or availability of staff. During the inspection staff were seen to promptly attend to residents needs. Staff also felt they had sufficient time to care and support the residents. Comments were “I feel safe working here”, “we work as a one team” and “a lot of training takes place”. Holly Tree Lodge Care Home DS0000034136.V266490.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 37 and 38 The home is well lead by a competent, well trained and committed manager. This in turn has given rise to a confident, supported and trained staff team. EVIDENCE: The manager has been registered by the Commission for Social Care Inspection. She is a registered nurse with 30 years experience in nursing practice and management. She and the deputy manager are studying for a management qualification. There are regular staff meetings the last being on the 16/9/2005. Staff also receive regular supervision. Residents, visitors and staff spoke of how they could approach the manager if they had any concerns. Comments were “I am very satisfied”, “I like it here”, the manager is very supportive and nothing is too much for her”, “I know what I am doing” and “I look forward to coming to work”. Holly Tree Lodge Care Home DS0000034136.V266490.R01.S.doc Version 5.0 Page 16 The last resident’s annual questionnaire was sent out in June 2005. There were very positive responses received. Specific comments were “my brother is pleased we found Holly Tree and consider the care to be excellent” and “there is a family atmosphere in this home” The Commission receives the detailed monthly monitoring visit reports carried out the owners. Staff felt safe working in the home and felt able to approach the manager if they had any concerns. Comments were, “ the manager is approachable and knows what is going on in the home”. The home had comprehensive policies and procedures. However there were no clinical procedures. In addition the home also had comprehensive health and safety policies, which also included risk assessments. A fire risk assessment was carried out in 2004 and an environmental risk assessment was carried out in September 2005. Holly Tree Lodge Care Home DS0000034136.V266490.R01.S.doc Version 5.0 Page 17 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 3 3 x 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 x x 3 x X 3 STAFFING Standard No Score 27 3 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 x x 3 3 Holly Tree Lodge Care Home DS0000034136.V266490.R01.S.doc Version 5.0 Page 18 no Are there any outstanding requirements from the last inspection? 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. 1 Refer to Standard OP37 Good Practice Recommendations It is recommended that the manager introduces clinical procedures in order to ensure that nursing procedures are up to date and in line with current researched practice. Holly Tree Lodge Care Home DS0000034136.V266490.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Tree Lodge Care Home DS0000034136.V266490.R01.S.doc Version 5.0 Page 20 - 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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