Inspection on 28/05/08 for Hollybank Nursing Home

This inspection was carried out on 28th May 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

Hollybank Nursing Home 20/01/10

Hollybank Nursing Home 20/01/09

Hollybank Nursing Home 31/05/07

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Hollybank Residential Care Home 211a Bolton Road Radcliffe Manchester Lancashire M26 3GN Lead Inspector Mike Murphy Unannounced Inspection 28th May 2008 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 Hollybank Residential Care Home DS0000068886.V364847.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. Hollybank Residential Care Home DS0000068886.V364847.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hollybank Residential Care Home Address 211a Bolton Road Radcliffe Manchester Lancashire M26 3GN 0161 723 5756 0161 724 9693 hollybankdualreg@btconnect.com 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) QNS Residential Limited Manager post vacant Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places Hollybank Residential Care Home DS0000068886.V364847.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories 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, The maximum number of service users who can be accommodated is: 30 Date of last inspection 31st May 2007 Brief Description of the Service: Hollybank is operated by QNS Residential Limited. The home provides 24-hour care for up to 30 older people. The property is on Bolton Road Radcliffe and is about one mile from the town centre. There is a bus stop on the main road close to the home and there are shops nearby. The accommodation is provided on two levels with a lift giving access to the first floor. The home has fourteen single bedrooms and eight rooms that are shared. Thirteen bedrooms have an en-suite toilet and hand basin. There are two lounges and there is a separate dining room. Toilets and bathrooms are provided on both floors. The home has a garden area with seating that can easily be reached from the conservatory. A Service User Guide that describes the home’s services is readily available in the home and the staff gives other information about the home to new and prospective residents and their families verbally. A copy of the latest inspection report, the home’s Statement of Purpose and copies of the home’s policies and procedures are also displayed in the home. At the time of this inspection the weekly charge for accommodation and services range from £365.94 to £370.00 with additional charges being made for hairdressing and chiropody services. Hollybank Residential Care Home DS0000068886.V364847.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This inspection which included a site visit that the home did not know was going to take place was carried out over a eight and a half hour period on the 28th May 2008. The process of inspection included observing what went on in the home, talking to residents, relatives, staff, and the home manager, looking round the home, and examining some important records. Before the inspection, we also asked the manager of the home to complete a form called an Annual Quality Assurance Assessment (AQAA) to tell us what they felt they did well, and what they needed to do better. This helps us to determine if the management of the home sees the service they provide the same way that we see the service. We felt this form was completed well. What the service does well: What has improved since the last inspection? A home manager has been appointed who is currently seeking to be registered with the CSCI. Discussion with the owner of the home revealed that a number of environmental improvements have been made since the last inspection. These improvements include re-decoration, replacement of some floor coverings and furniture in those parts of the home occupied by residents. A programme of work and refurbishment is planned to further improve the home environment for residents. Hollybank Residential Care Home DS0000068886.V364847.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. The summary of this inspection report can be made available in other formats on request. Hollybank Residential Care Home DS0000068886.V364847.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 Hollybank Residential Care Home DS0000068886.V364847.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents are appropriately assessed prior to admission to ensure the home can meet their care and support needs. EVIDENCE: The pre-admission assessment records of 2 residents admitted to the home over the last 3 months were looked at. Before residents are admitted to the home an assessment of their needs is carried out in consultation with the resident (where possible), their relatives and relevant health and social care professionals such as doctors and social workers. The reason for such an assessment is to help the prospective resident (and their relatives) decide how appropriate a placement at the home would be and enable the person conducting the assessment to determine if the home will be able to meet the prospective resident’s needs appropriately. Hollybank Residential Care Home DS0000068886.V364847.R01.S.doc Version 5.2 Page 9 The initial assessment helps to form the basis of the plan of care to be followed following admission to the home. The 2 residents care records inspected contained detailed pre-admission assessments. Relatives spoken to indicate that they were involved in the pre-admission process and that their views were important in the process. Standard 6 does not apply as intermediate care is not provided. Hollybank Residential Care Home DS0000068886.V364847.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9, and10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The health and personal care provided is suitable, however records need to be improved to ensure peoples care needs and risks are properly documented and kept up to date. EVIDENCE: The care records of three residents (out of 15 residents at the time of this visit) were inspected. It was found that care plans need to be updated and address the health and personal care needs of residents in a clearer, more organised way and be evaluated at least monthly. Risk assessments, that seek to protect resident’s health and welfare should supplement the care plans in respect of residents skin integrity (assessing the risk of pressure sores), mobility/moving and handling, nutrition, (including regular weight monitoring) and other areas of potential risk for individual residents should also be in place for all residents and be assessed at least monthly. Daily statements regarding resident’s Hollybank Residential Care Home DS0000068886.V364847.R01.S.doc Version 5.2 Page 11 progress are also recorded and these are dated, and signed by staff but some were not timed. Also some of the risk assessments, daily statements and care plan evaluations had not been signed properly - such records should be signed appropriately to clearly identify the person making the entry. The need to improve care records was discussed in detail with the new home manager and the person who owns the home on the day of inspection. All residents are registered with a local GP and it was evident that all were enabled to access the services of dieticians, opticians, chiropodists, dentists, district nurses and other specialist services as individual residents needed. Discussion with resident’s relatives on the day of inspection indicated that they are kept informed of all changes in their relation’s health. Resident’s medicines were being appropriately managed. They were safely stored and documented. Medicines are administered by senior staff who have had recently updated training in how to manage and administer resident’s medicines safely. Discussion with residents and staff revealed that residents were treated with respect and that privacy was upheld and dignity respected. Comments made included; ‘the staff are very nice and look after me well’, ‘they are all very nice and I am happy here’, ‘I have been here a long time and like it’. On the day of inspection staff were observed to interact positively with residents and show them respect, protect their dignity and assist them properly throughout the day. Resident’s relatives spoken to were of the view their relation’s are treated with respect and cared for in a dignified way. Hollybank Residential Care Home DS0000068886.V364847.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are encouraged and enabled to maintain family and community contacts and participate in social activities. They are also encouraged to make personal choices in their daily life and there was a high level of satisfaction with food provision at the home. EVIDENCE: A part-time activities organiser was being recruited at the time of this inspection. A range of leisure and social activities were available for groups of or individual residents. The home had recently held a well-attended BBQ day that was popular with residents and relatives. Entertainers visit the home periodically. Residents say they can choose what to/not to participate in. Discussion with the manager indicated that social and leisure activities are to be reviewed once the new activities organiser commences work. Residents say they are able to make as many choices as possible in their daily lives. For example when they get up, go to bed, what and where to eat, and when and where they receive their visitors. Residents and their relatives said that there continues to be no unreasonable restrictions to visiting at the home. Hollybank Residential Care Home DS0000068886.V364847.R01.S.doc Version 5.2 Page 13 The only time restrictions would be imposed is when requested by residents. Relatives spoken to during the inspection said they were always made welcome at the home and were able to see their relatives in the privacy of their own rooms. Residents wishing to maintain their religious links are enabled to do so. Meals are cooked on site in the home’s kitchen. Meals are varied, balanced and the menu (that was being reviwed at the time of inspection) provides choice – 3 meals a day plus supper are provided – also snack food/drink is available at all times. Meals are prepared in a central kitchen on site. However menus were not prominently displayed for all to view. The dining room was suitably furnished and provides a pleasant area for resident’s to take their meals. Lunch was observed on the day of inspection – this was a hot substantial meal, providing choice, good portions and residents were appropriately/sensitively supported by staff. Staff wore disposable aprons and residents clothing was suitably protected. Residents can choose to eat in their own room if preferred. Medical, religiousand vegetarian diets were being catered for. The consensus view from residents is that the food is very good and that an alternative to the menu can always be obtained if requested and that this is supplied willingly. Hollybank Residential Care Home DS0000068886.V364847.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents and relatives knew how to make a complaint if they felt it necessary. However training arrangements need to be implemented to ensure all staff are provided with current knowledge of safeguarding so that people are protected from abuse. EVIDENCE: The complaints procedure was prominently displayed and is also available in the ‘Service users guide’ that is provided for resident’s and their relative’s information. A complaints log is maintained that details the nature of the complaint, how it has been investigated and the outcome. The home operates safeguarding and whistle-blowing policies that seek to protect residents. In addition, a copy of Bury’s Inter agency protection procedure is held on site. Staff spoken to confirmed that they had safeguarding training in the past (but could not say when) and were aware of the ‘whistleblowing’ policy. Appropriate pre-employment checks are conducted on all staff to ensure they are suitable to look after the resident’s. Detailed training records were not in place. The importance of providing current safeguarding training was discussed with the manager and owner of the home on the day of this inspection. Discussion with residents reflected that they felt safe at the home. Hollybank Residential Care Home DS0000068886.V364847.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20,21,22,24 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is structurally well maintained throughout and provides a suitable and comfortable environment for the care of residents. EVIDENCE: A tour of the home was made during this inspection. All communal lounges and dining rooms were inspected and twelve resident’s bedrooms. All areas were clean and warm and suitably ventilated. Discussion with the owner of the home revealed that a number of environmental improvements have been made since the last inspection. These improvements include programmes of re-decoration, replacement of some floor coverings and furniture in those parts of the home occupied by residents. A programme of work and refurbishment is planned to further improve the home environment for residents. Hollybank Residential Care Home DS0000068886.V364847.R01.S.doc Version 5.2 Page 16 Lounge and dining areas were clean adequately decorated and suitably and comfortably furnished. Bedrooms inspected were clean, suitably furnished and equipped and in a number of cases very personalised – all bedrooms have been re-decorated since the last inspection. Aids and adaptations have been made generally to the environment to assist and enable residents and appropriate hoisting equipment is available. The garden areas at the home are well maintained and accessible to all residents. The laundry area has been moved to the ground floor since the last inspection. The laundry was adequately equipped and staffed and the arrangements to provide residents with a laundry service were suitable and appropriate. Measures were in place to prevent the spread of infection such as suitable protective clothing for staff, cleaning programmes and hand washing arrangements. Malodour was being managed well specifically in areas of the home where it can be a challenge. All residents have their continence needs assessed and are provided with aids and support to appropriately deal with those needs. Hollybank Residential Care Home DS0000068886.V364847.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The recruitment and provision of staff employed at the home are managed appropriately. Some aspects of staff training need to be developed to ensure residents are cared for adequately and appropriately by staff able to deliver this support safely and competently. EVIDENCE: Staffing records showed that care staff were on duty at all times and that, in addition to care staff, the home employs a manager, administrator, a cook, kitchen assistants, laundry staff, maintenance and housekeeping staff to ensure that residents needs can be met appropriately. Staffing provision for the 15 residents living at the home at the time of this inspection was in the view of the manager, staff, residents and relatives spoken to appropriate for the needs and dependency levels of residents. However the manager was mindful that increasing resident’s numbers necessitates constant review of staffing levels. Over 50 of the care staff have achieved an NVQ 2 (or above) and many have worked at the home for a number of years. Whilst it was evident ongoing staff Hollybank Residential Care Home DS0000068886.V364847.R01.S.doc Version 5.2 Page 18 training was being re-organised a clear record of training needs to be developed for each member of staff indicating the date of training provided, the type of training provided and when an update to that training will be due. This is important to demonstrate staff are trained to care and support residents appropriately. It is our view that accessing safeguarding training for all staff should be a priority in respect of staff training at the home. It is also recommended that in view of the number of residents who experience confusion staff at the home should be enabled to access training in dementia awareness. 3 staff recruitment files were inspected on this occasion. They contained evidence of CRB checks (including POVA first checks), 2 written references, criminal convictions declarations, a recent photograph, proof of identity, and completed application forms – these included a detailed work history and a declaration relating to the prospective employees health status. Hollybank Residential Care Home DS0000068886.V364847.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The registered manager needs to address the requirements and recommendations made as a result of this inspection to ensure management systems at the home are fully effective. EVIDENCE: A new home manager has been appointed since the last inspection. The home manager is very experienced in managing care and support services for older people and holds the registered managers award (RMA). The manager was in the process of applying to the CSCI to be the registered manager for Hollybank care home. Senior care staff and an administrator support the manager in her role. The homeowner also provides support on a daily basis. Hollybank Residential Care Home DS0000068886.V364847.R01.S.doc Version 5.2 Page 20 Discussion with residents, their relatives and staff indicate that the manager is accessible and operates an open door policy and also adopts an approach that enables issues to be easily discussed with her and that emphasis is placed on operating the home in the best interests of the residents. However the issues identified in this report in respect of care planning, risk assessments and training, should be addressed by the manager. The manager operates procedures that seek to ensure the quality of the service provided is good – and where it is identified as not being up to standard takes appropriate action to rectify the situation. Residents (if able) are encouraged to control their own money. However where they are unable to relatives manage their personal allowances. At the time of this inspection no resident’s personal allowances were being managed by the home. Documentary evidence was seen of electrical safety. However a current gas safety certificate was not available for inspection. The premises were secure at the time of this unannounced inspection. Hot water temperatures were being monitored regularly and the inspector was informed all immersion baths and showers are fitted with devices that are intended to prevent burns. The passenger lift and hoisting equipment used in the home is serviced regularly. Hollybank Residential Care Home DS0000068886.V364847.R01.S.doc Version 5.2 Page 21 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 2 3 3 3 3 X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 2 Hollybank Residential Care Home DS0000068886.V364847.R01.S.doc Version 5.2 Page 22 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. 1 Standard OP7 Regulation 15 (1)(2) Requirement That care plans and risk assessments address the health and personal care needs of residents in a clearer, more organised way and be evaluated at least monthly That the CSCI is informed in writing what arrangements have been made to provide updated safeguarding training for staff employed at the home That the CSCI is provided with a copy of a record of training that identifies the date of training provided, the type of training provided and when an update to that training will be due for all staff employed at the home. That it is confirmed to the CSCI in writing that there is a current certificate of gas safety in respect of the home Timescale for action 31/07/08 2 OP18 13(6) 31/07/08 3 OP30 18(1)c 31/07/08 4 OP38 13(4) 31/07/08 Hollybank Residential Care Home DS0000068886.V364847.R01.S.doc Version 5.2 Page 23 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 3 4 5 Refer to Standard OP7 OP9 OP9 OP12 OP15 Good Practice Recommendations That daily statements/progress records are timed and signed in full That specimen signatures are recorded for staff who make entries in care records and/or administer medicines That a record of returned/disposed of medicines is maintained That the activities programme is prominently displayed in the home That menus are prominently displayed in the home Hollybank Residential Care Home DS0000068886.V364847.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Manchester Local office 11th Floor West Point 501 Chester Road Manchester M16 9HU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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