Inspection on 24/08/06 for Holly Tree Lodge Care Home

This inspection was carried out on 24th August 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 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 Tree Lodge Care Home 18/03/09

Holly Tree Lodge Care Home 13/08/08

Holly Tree Lodge Care Home 01/12/05

Holly Tree Lodge Care Home 15/12/04

Holly Tree Lodge Care Home 12/07/04

Holly Tree Lodge Care Home 12/01/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Byars Care Home

St Marys Nursing Home

Jubilee Villa Care Home

Bramble Lodge

Parkmanor Residential Home

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

CARE HOMES FOR OLDER PEOPLE Holly Tree Lodge Care Home 3 Eastgate Scotton Gainsborough Lincs DN21 3QR Lead Inspector Mr Doug Tunmore Unannounced Inspection 24th August 2006 09:00 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.V309211.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 Tree Lodge Care Home DS0000034136.V309211.R01.S.doc Version 5.2 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.V309211.R01.S.doc Version 5.2 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. 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 32 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. The current scale of charges at this home is from £335.00 to £415.00. Holly Tree Lodge Care Home DS0000034136.V309211.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced and took into account any previous information held by Commission for Social Care Inspection (commission) including the homes previous inspection reports, their service history, the homes pre-inspection questionnaire and residents questionnaires sent to the home by the Commission prior to this inspection. The site inspection consisted of case tracking a sample of two resident’s records and assessing their care. The inspector spoke with one of the residents who was being case tracked and joined three other residents for lunch. The inspector also spent time with the operations director, the manager and one member of staff. Two visitors were also spoken to. A partial tour of the home and a review of a sample of the records was also included. What the service does well: What has improved since the last inspection? The operations director stated that as part of the homes refurbishment programme the home has a new car park, the driveway has been resurfaced and new patios have been built in the main house garden and in the elderly mentally infirm unit garden. Also new curtains have been fitted in the dining room and bedrooms. Holly Tree Lodge Care Home DS0000034136.V309211.R01.S.doc Version 5.2 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.V309211.R01.S.doc Version 5.2 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.V309211.R01.S.doc Version 5.2 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): 2, 3 & 6 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. The home has a comprehensive care needs admission assessment, which helps to ensure that a residents needs would be met. EVIDENCE: A review of all information available prior to this inspection, including previous inspection reports dated 27/06/05 and 01/12/05 and evidence seen at this inspection in residents files and care plans, showed that the home does not admit residents without a care needs assessment being undertaken. Prospective residents are also written to by the home confirming that they can meet the residents care needs or not. 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.V309211.R01.S.doc Version 5.2 Page 9 The commission sent resident’s questionnaire forms to the home prior to this inspection and twelve were returned. Relatives of residents completed the majority of questionnaires. All questionnaires except one confirmed that residents had information about the home prior to admission and the same number also agreed that they had received a contract. Written comments made in questionnaires were; a care plan was drawn up and the home was very helpful and provided all the information and documentation requested. The care staff were very helpful. One resident said that she was visited in hospital by the manager who discussed her care needs with her, before admission to the home. A sample of a contract was sent to the commission and the two residents who were being case tracked had a contract in their files, setting out the terms and condition of their stay. Holly Tree Lodge Care Home DS0000034136.V309211.R01.S.doc Version 5.2 Page 10 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): 7,8,9,10 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. Care plans are in place and provide information to enable residents to develop their lifestyles as they may wish. The providers do not ensure that residents are empowered at their Care needs reviews. EVIDENCE: A previous inspection undertaken on December 05 showed that ‘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’. A Local Authority contracting monitoring visit was undertaken on the 01/06/06 and examined residents files; it was seen that, ‘these were found to be up to date and well maintained’. Holly Tree Lodge Care Home DS0000034136.V309211.R01.S.doc Version 5.2 Page 11 This inspection also showed that GPs, community nurses and chiropodists visit the home on a regular basis to attend to the health care needs of residents. Those files of residents who were being case tracked were found not to have empowered residents in respect to ensuring that they signed their care needs reviews. This needs to be undertaken to ensure that any changes to their care is jointly agreed between the manager, residents or representatives. One residents care plan review had not been signed since 25/11/04. The questionnaires returned by residents showed that seven felt that they always receive the medical support that they need and four felt that they usually received the medical support that they need. Resident’s questionnaires also showed that nine felt that they received the support that they need and three said that they usually receive the support that they need. Five residents commented that they felt that staff are always available when they need them and seven felt that staff are usually available when they need them. Written comments made by relatives were, ‘staff are always available ,they do get over stretched at times, but they do cope’. ‘I have filled this form in for my mother who has improved greatly since being at this home. I am very grateful to them’. The commission has received copies of written accolades concerning the home from relatives voicing praise for the services provided. Samples of these are as follows; ‘Our very heart felt thanks and best wishes to all the staff’, ‘We would like to thank you for being so kind to our mum’. Two visitors seen on the day of the inspection stated that they are regular visitors and have a copy of their relatives care plan at home. They also commented that their relative ‘ is very well cared for and treated with respect, the nurses are friendly and warm and mum responds to that’. The pharmacist inspected the home in September 2002 and recorded that medication was maintained mostly satisfactorily. Resident’s medication sheets were seen and it was found that; one medication sheet had not been signed by the duty nurse to show that medication had been given and taken by the resident. The provider should arrange with the pharmacist for regular inspections to ensure that the administration of medication is undertaken. The homes training plan showed that five nurses had undertaken a safe handling of medication course (distance learning) in April 2006. Holly Tree Lodge Care Home DS0000034136.V309211.R01.S.doc Version 5.2 Page 12 One resident confirmed that she is treated with respect and ‘staff talk to me when they bath me, they are very good’. Holly Tree Lodge Care Home DS0000034136.V309211.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 &15 The quality outcome in this area is excellent. This judgement has been made using available evidence including a visit to this service. A range of stimulating activities are made available to residents, with relatives encouraged to join in and have lunch at the home. EVIDENCE: Previous inspections have found that the home has an activities programme. The Commission has received prior to this inspection, from the provider, an activity and entertainments programme dated from January to August 2006. Activities include crafts, ball games, bingo, Easter Parade, Easter fayre, reminiscences and entertainers. The home has an external occupational therapist to take crafts every Tuesday. One resident’s questionnaire showed that there are activities and they are available to her always, six residents commented that activities are usually available and families have commented that other residents require full nursing care. One relatives written comment was that ‘I find the staff at Holly Tree Lodge fantastic, they show a lot of affection and patients’. Holly Tree Lodge Care Home DS0000034136.V309211.R01.S.doc Version 5.2 Page 14 Two visitors stated that their relative does not undertake activities due to her illness. A residents said that she joins in card or board games but will not be going on the Cleethorpes outing in the morning. The manager stated that a trip to Cleethorpes has been arranged and relatives are attending to offer support. The Local Authority contracting monitoring visit found that ‘ residents have access to activities if they wish to participate. Visitors are actively encouraged to come to see their relatives and support in any way possible’. This visit also found that, residents have a varied and menu and fresh produce is purchased and cooked on site. The inspector joined three residents for lunch and was informed that the food is always fresh and choices are available. Three staff and the cook were seen to be supporting residents to eat during lunch. They were sensitive to the residents needs and coaxed them to eat as much as they required. The home has again been awarded a Food Safety Award on the 30/11/2005. Resident’s questionnaires showed that five always liked the meals and six usually liked the meals provided. Holly Tree Lodge Care Home DS0000034136.V309211.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. The home provides a safe environment in which residents are protected from abuse. EVIDENCE: Previous inspections of this home have shown that a detailed complaints procedure is in place. The homes complaints pre-inspection questionnaire recorded that that two complaints had been made in the last year, one of which is currently ongoing. This complaint was discussed with the operations director and manager who are to refer this complaint to the Social Services Department for their information. Resident’s questionnaires showed that seven residents were aware of how to make a complaint and ten knew who to speak to if they were unhappy. Written comments made were that, ‘I am always listened to’. One resident confirmed that if she had a concern she ‘would see Pam (the manager) who is very good’. Holly Tree Lodge Care Home DS0000034136.V309211.R01.S.doc Version 5.2 Page 16 Those residents seen at lunch expressed no concerns 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. The homes training profile shows that safeguarding vulnerable adults training has been undertaken by all care workers on May 06. Holly Tree Lodge Care Home DS0000034136.V309211.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained and is clean and tidy, with a pleasant smell throughout. EVIDENCE: Holly Tree Lodge Care Home DS0000034136.V309211.R01.S.doc Version 5.2 Page 18 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. A tour of the home found that it was clean and well aired and no unpleasant odours were evident. The home has a planned repairs and maintenance programme for each month, with the operations manager sending a monthly report to the Commission detailing changes to the home. Residents said how satisfied they were with the decoration and cleanliness of the home. They all spoke of how much they liked their bedrooms. The residents survey overwhelming confirmed that the home always smells nice and is clean and tidy. Holly Tree Lodge Care Home DS0000034136.V309211.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. The home maintains appropriate staffing levels and has a robust recruitment and training practices. EVIDENCE: The Local Authority contracting monitoring visit found that ‘ a sample of personnel, induction and training records were examined and were seen to be in good order’. The manager stated that she had given The General Social Care Council Codes of Practice, which sets out their responsibilities as care workers looking after vulnerable adults, to all carers as part of their induction training. The home has five care staff trained to NVQ level 2 and two workers training to NVQ level 3. The homes pre-inspection questionnaires evidences that 22 of carers have NVQ (National Vocational Qualifications) which means that the home does no meet the ratio of 50 of care staff trained to level 2. The homes duty rota was seen and it was found to be an accurate record and showed that adequate staffing levels are maintained to meet the needs of residents. There is one nurse waking night staff three carers. Holly Tree Lodge Care Home DS0000034136.V309211.R01.S.doc Version 5.2 Page 20 A resident commented that ‘there is enough staff day and night if you want them’. During the day of the inspection staff were observed carrying out their duties in a sensitive and caring manner. Two visitors stated that ‘there always seems to be enough staff on duty’. A carer confirmed that ‘most of the time there is enough staff, but due to spending time with a new resident this morning its been a bit hectic, on the whole things run smoothly’. Holly Tree Lodge Care Home DS0000034136.V309211.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33, 35, & 38 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. The home is managed in a manner that promotes residents health and safety needs. Records are well maintained with policies and procedures regularly updated. EVIDENCE: The registered manager is qualified and experienced in running this home for older people and has one module to complete to gain the registered managers award. The operations manager visits the home on a monthly basis and undertakes an audit, with a copy of the report being sent to the commission. Holly Tree Lodge Care Home DS0000034136.V309211.R01.S.doc Version 5.2 Page 22 The Local Authority contracting monitoring visit found that ‘the home is welcoming and there is a good atmosphere and staff and residents clearly have a good rapport’. A resident commented that the ‘staff are very good here and the manager is very nice and very approachable’. The home conducts an in house quality assurance (QA) report. The quality assurance report is not posted for the information of residents and visitors. A sample of the homes internal audit was seen and showed that comments were positive in respect to the care provided to residents. The operations director confirmed that he is to undertake a wider audit in the future to cover all aspects of the running of the home. The Local Authority contracting monitoring visit also checked residents finances and found that ‘financial matters are dealt with by the administrator, a sample of residents records were examined and found to be accurate and well maintained with robust systems.’ There are a range of policies and procedures available in the home relating to fire safety and fire risk assessments. The homes pre-inspection questionnaire evidenced that fire alarm, fire drills and emergency lighting checks have been undertaken. A check of the fire log was undertaken and it was found to be up to date. Care staff also receive fire training as part of the homes initial training and as a regular training event. The homes pre-inspection questionnaire has evidenced that maintenance and service histories of all aids and adaptations are carried out as required by law. Holly Tree Lodge Care Home DS0000034136.V309211.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 x 3 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Holly Tree Lodge Care Home DS0000034136.V309211.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. 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.V309211.R01.S.doc Version 5.2 Page 25 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. 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