Inspection on 20/02/07 for Hollybank House

This inspection was carried out on 20th February 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 11 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hollybank House 25/09/07

Hollybank House 24/01/06

Hollybank House 19/07/05

Hollybank House 25/01/05

Hollybank House 09/06/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Hollybank House Church Street Stacksteads Bacup Lancashire OL13 0RW Lead Inspector Mrs Lynn Mitton Unannounced Inspection 20 February 2007 10:00 th Hollybank House DS0000009600.V312668.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Hollybank House DS0000009600.V312668.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Hollybank House DS0000009600.V312668.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hollybank House Address Church Street Stacksteads Bacup Lancashire OL13 0RW 01706 877659 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) Ms Susan Footitt Ms Mary Lorraine Moden Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Hollybank House DS0000009600.V312668.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to accommodate up to a maximum of 5 residents in the category of LD (learning disability) 24th January 2006 Date of last inspection Brief Description of the Service: Hollybank House is registered with the Commission for Social Care Inspection to provide personal and social care for up to 5 adults with a learning disability aged over 18 years. At the time of the inspection there were four people accommodated. The home is a terraced property located off a busy main road, on the outskirts of Stacksteads. Rawtenstall town centre is approximately four miles away in one direction Bacup approx 1.5 miles in the other. The home offers 5 single bedrooms, two being en-suite. There is one lounge and one conservatory. The home is tastefully decorated and maintained to a high standard throughout. The proprietor aims to offer a homely environment within structured and consistent guidelines. Hollybank House opened in 1998. Residents are Local Authority funded. Fees for the cost of a weeks care at Hollybank House range from £450.00 and £500.00. There was information available to potential residents advising them of the home and giving them details about the type of service they could expect. Hollybank House DS0000009600.V312668.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key unannounced inspection, which included a visit to the home, was conducted on 20th February 2007. There were 4 residents accommodated at this time. A tour of the communal areas of the home took place. Over the course of the inspection 2 of staff on duty were spoken to, and interaction between the residents and staff members were observed. Throughout the report there are references to “case tracking”, this is a method whereby the inspector focuses on a small representative group of residents and care staff. Records regarding these people were inspected. Policies and practices were also read. Three residents relatives had completed the Commission’s “Have your say” comment card, and these indicated that overall they were satisfied with the level of service at Hollybank House. What the service does well: Residents were supported in taking responsible risks and independence was promoted to the best of individual ability. The home was run to make sure that residents had opportunities to enjoy their life and to fulfil their potential. Residents were able to make day-to-day decisions about their lives, and had opportunities to fulfil their potential. Individual dietary needs were catered for. One resident told the inspector; “Its OK here I go to the day centre one day a week and to a gardening project one day a week. I enjoy going to the pub to play Bingo on Tuesdays. I go shopping with the staff, and I bake sometimes. I get on well with the staff, they look after me. I usually get on well with the other guys who live here”. Personal support was given to residents in a way that empowered them and promoted dignity and choice. The standard of décor and furnishings provided a comfortable and homely environment for residents. Staff spoken to and observed by the inspector demonstrated a good understanding of the needs of the residents. Hollybank House DS0000009600.V312668.R01.S.doc Version 5.2 Page 6 Regular 1:1 supervision ensured that each staff member was clear about what was expected of them. By talking to the residents of the home it was clear that the attitude of the staff and management was to run the home with the needs of the residents as the highest priority. What has improved since the last inspection? What they could do better: Needs assessments must be in place for all residents, identifying their care needs so that support staff would have a clear understanding of what they must do to support them. Up to date contracts must be in place for all residents, explaining what residents could expect, and what was expected of them in order for them to live at Hollybank House. Detailed information on care plans would ensure that support staff could meet resident’s needs in a thorough and consistent way. Minor amendments would ensure good practice was in place with regards to the administration, safekeeping, storage and disposal of resident’s medication. Complaints and protection policies and practices needed further updating and revision, to ensure that all residents could understand them. Staff training was needed to ensure that all staff were familiar with abuse procedures and protection of vulnerable adults issues. Recruitment and selection procedures do not fully protect residents. Residents were not formally consulted about the running of the home. Further training as identified would ensure the safety and welfare of residents and staff. Hollybank House DS0000009600.V312668.R01.S.doc Version 5.2 Page 7 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. Hollybank House DS0000009600.V312668.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hollybank House DS0000009600.V312668.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA2, YA5 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Needs assessments must be in place for all residents, identifying the care needs of residents so that support staff would have a clear understanding of how they needed to support them. Up to date contracts must be in place for all residents, explaining what residents could expect, and what was expected of them in order for them to live at Hollybank House. EVIDENCE: One resident wrote; “When I came for a visit I was given information and shown round”. There had been no new admissions to the home since the last inspection. The inspector noted that no evidence of an assessment of need could be found for the resident case tracked. Residents contracts had previously been in place, however no evidence could be found of a contract for the resident case tracked were seen. Hollybank House DS0000009600.V312668.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA6, YA7, YA9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A lack of detailed information on care plans does not enable support staff to meet resident’s needs in a thorough and consistent way. Residents were supported in taking responsible risks and independence was promoted to the best of individual ability. EVIDENCE: One residents care plan was examined. This documents contained some information about the level of support needed for staff to ensure continuity of care. The inspector and staff on duty discussed at length the content and detail of these plans and how they should be improved. There was no photograph in place. Daily records were seen and their content was good. Hollybank House DS0000009600.V312668.R01.S.doc Version 5.2 Page 11 Five risk assessments were seen on the care plan. These included information explaining, once the risk had been identified, how it would be managed, and what action was to be put in place to reduce the risk to an acceptable level. One resident wrote; “ we can bake cakes, go out in the car and go on holiday”. All residents had a next of kin who represents their best interests. Resident’s personal allowances were managed with the support of the care staff. One resident’s purse was checked and was found to be in order. Hollybank House DS0000009600.V312668.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA12, YA13, YA15, YA16 & YA17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was run to make sure that residents had opportunities to enjoy their life and to fulfil their potential. Residents were able to make day-to-day decisions about their lives, and had opportunities to fulfil their potential. Individual dietary needs were catered for. EVIDENCE: One resident told the inspector; “Its OK here I go to the day centre one day a week and to a gardening project one day a week. I enjoy going to the pub to play Bingo on Tuesdays. I go shopping with the staff, and I bake sometimes. I get on well with the staff, they look after me. I usually get on well with the other guys who live here”. Another resident said; “I like going to McDonalds and shopping. I go to see my mum every week and my sister rings me.” Hollybank House DS0000009600.V312668.R01.S.doc Version 5.2 Page 13 Residents had regular access to their local community; and activities accessed within the local community included the local supermarket, Gateway social club and local pubs for bingo/drink/meals. Each resident had an individual activity programme, which included community-based activities. The inspector noted that the resident case tracked did not have an up to date activity programme in place. Residents usually had access to a vehicle, which they used to access the wider community. The inspector was advised that no residents expressed a wish to attend church. Residents were supported in maintaining family relationships. One resident told the inspector; “I’m going on holiday with my family in June”. Another resident said; “I go to see my family for an overnight stay every fortnight”. The inspector was advised that all residents had had a holiday and days out. The inspector observed residents being spoken to with respect and support staff were also observed respecting residents rights and wishes. One resident wrote; “We all make decisions together”. A record of food eaten by residents was kept. The inspector advised that more detail should be kept on these records, as there was not a set menu in place. Staff encouraged residents to help prepare food in the kitchen under staff supervision. An environmental health food inspection had taken place in February 2007. Hollybank House DS0000009600.V312668.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA18, YA19 & YA20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Personal support was given to residents in a way that empowered them and promoted dignity and choice. Resident’s health needs were not being recorded clearly. EVIDENCE: One resident wrote; “ I clean my room and kept it tidy”. Care staff were seen to encourage the residents to be as independent as possible regarding their personal care. Privacy was facilitated and respected. The routines regarding personal care were flexible, and based on each resident’s needs and abilities. The resident case tracked had a health assessment review document dated October 2006. This document appeared to be an amalgamation of previous health check/assessments and it was not clear if any changes had been made or recorded. The development of these documents was discussed at length with the members of staff on duty at the time of the inspection. Policies and practices for managing and administering medication were in place. Minor details (for example the name of the current pharmacist) needed amending in order to ensure the document contained accurate information. Hollybank House DS0000009600.V312668.R01.S.doc Version 5.2 Page 15 Medication was administered using the Nomad Monitored Dosage System. Residents had their medication administered by care staff. Patient Information leaflets were in place. Administration records seen were completed correctly. The inspector advised that the pharmacist should supply medication administration records as handwritten sheets leave potential for error. Most staff had completed training to ensure that they administer medication safely. Hollybank House DS0000009600.V312668.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA22 & YA23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Current complaints and protection policies were not easy for residents to understand. Not all staff were trained or familiar with abuse procedures and protection of vulnerable adults issues. EVIDENCE: One resident wrote; “If I was unhappy I would talk to the staff”. There had been one complaint since the last inspection. The complaints policy was seen and had been reviewed in June 2006. There was not a complaint procedure in place. The inspector advised that consideration should be given to make the procedure in a format that may be understood by the residents i.e. in a pictorial format. The protection policy was seen this had been reviewed in July 2006. The policy of abuse and whistle blowing policy was also seen. The inspector advised that these documents needed updating and more detail. Staff had not recently undertaken prevention of abuse training. POVA 1st training was outstanding for all the staff team. Hollybank House DS0000009600.V312668.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA24 & YA30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of décor and furnishings provided a comfortable and homely environment for residents. EVIDENCE: The inspector conducted a tour of the homes communal areas, and noted that the new conservatory was being well utilised. The inspector advised that the staircase and landing carpet was in need of replacement. Sky TV had been installed. 2 residents bedrooms had been redecorated and the trees in the front garden had been removed. The inspector advised that a doorbell would be beneficial. The home was clean and odour free. Suitable laundry facilities were in place. Hollybank House DS0000009600.V312668.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA32, YA34 & YA35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Regular 1:1 supervision ensured that each staff member was clear about what was expected of them. Recruitment and selection procedures do not fully protect residents. EVIDENCE: One resident wrote; “The staff are wonderful, nice and generous, my key worker is a lovely lady. The registered person is a mother to me and one worker is my best friend. The staff are all very nice and they make me laugh”. Another resident said; “I feel I can talk to the staff better than anybody else. The staff always treat me well”. Another resident wrote; “The staff at Hollybank House are great they take good care of me and are good listeners”. The inspector noted that out of the care staff team of 6, 4 care staff members had completed their NVQ level 3 or NVQ2 training. 1:1 supervision with staff was diarised at 6 weekly intervals, and team meetings every 8 weeks. 1:1 appraisals were diarised for all staff within the next week. Minutes from the Hollybank House DS0000009600.V312668.R01.S.doc Version 5.2 Page 19 previous two meetings were seen. The inspector and staff on duty discussed staff files security. A training matrix was out of date and a training and development plan for the home had been completed but was in need of updating. Evidence was seen on the staff members case tracked of training, this included; health and safety in the workplace, food hygiene, safe handling of meds, Emergency 1st aid, Infection control The inspector noted that a basic induction checklist was in place, and advised that LDAF induction and foundation training must be available to new all staff. The inspector case tracked 3 employee files; there was some information available to the inspector, however one staff’s application form could not be found and 2 references could not be found on another staff member case tracked. The inspector advised that the application form and appraisal format be reviewed to include more detail. Detailed terms and conditions of employment were in place, but not signed by one staff member. The inspector observed residents being supported by competent staff, and there were at least two care staff members on duty at any time, and two staff sleeping in overnight. Hollybank House DS0000009600.V312668.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA37, YA39 & YA42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The attitude of the staff and management was to run the home with the needs of the residents as the highest priority. Residents were not formally consulted about the running of the home. EVIDENCE: The registered person had undertaken appropriate training, and works “hands on” at the home at least 36 hours each week. Since the previous inspection, a practice manager has been employed for 12 hours per week. Residents surveys had not been conducted since October 2005. The inspector advised that the visitors book must be completed each time visitors come to the home. A business plan was in place, this document was in the process of being reviewed at the time of the inspection. Hollybank House DS0000009600.V312668.R01.S.doc Version 5.2 Page 21 The inspector noted a number of up to date safety certificates issued with regard to the routine maintenance and safety of Hollybank House. Staff had now completed food hygiene, health and safety and safe handling of medication training. The inspector advised that evidence should be demonstrated that the homes smoke alarm batteries are being tested. Training issues regarding safe working practices were identified as outstanding for some staff, for example Fire Safety Training. Hollybank House DS0000009600.V312668.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 1 3 X 4 X 5 1 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 3 12 2 13 3 14 X 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 X 2 3 X 2 X X 2 X Hollybank House DS0000009600.V312668.R01.S.doc Version 5.2 Page 23 Yes 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. 1. Standard YA2 Regulation 14(1) Requirement The registered person must have a copy of the assessment in order to ascertain that the home can meet their needs. The registered person shall produce terms and conditions in respect of accommodation to be provided including the amount and method of payment of fees. Written care plans describing how each residents needs are to be met must be in place. Make and promote proper arrangements for the health and welfare of residents. The registered person shall make arrangements for the recording, handling, safe keeping, administration and disposal of medication. The complaint policies and practices must be in accordance with this legislation. The registered person must ensure that by staff training or other measures, to prevent residents from harm, abuse or being placed at risk or harm or abuse. Documentary evidence as DS0000009600.V312668.R01.S.doc Timescale for action 29/06/07 2 YA5 5(1)(b) 29/06/07 3. 4 5 YA6 YA19 YA20 15(1) 12(1) 13(2) 03/08/07 29/06/07 29/06/07 6 7 YA22 YA23 22 & Schedule 4 (11) 13(6) 03/08/07 03/08/07 8. YA34 Schedule 03/08/07 Page 24 Hollybank House Version 5.2 2 9 YA35 18 (1)(c) 10. 11. YA39 YA42 Schedule 4(17) 13(4c) described in Schedule 2 of the Care Home Regulations must be kept at the home and be available to the inspector. The registered person shall ensure that persons employed at the care home shall receive training appropriate to the work they are to perform. A record must be kept of all visitors to the home. Risks to residents health and safety are identified and so far as possible eliminated, in that all staff receive appropriate training. 03/08/07 03/08/07 03/08/07 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. 2. Refer to Standard YA12 YA17 Good Practice Recommendations Residents activity programme should contain up to date information. Accurate records of resident’s dietary intake should be recorded. Hollybank House DS0000009600.V312668.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB 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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