Inspection on 14/07/05 for Hollydene EMI Rest Home

This inspection was carried out on 14th July 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.

Other inspections for this house

Hollydene EMI Rest Home 14/05/08

Hollydene EMI Rest Home 28/06/07

Hollydene EMI Rest Home 31/08/06

Hollydene EMI Rest Home 30/01/06

Hollydene EMI Rest Home 16/02/05

Hollydene EMI Rest Home 06/09/04

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

CARE HOMES FOR OLDER PEOPLE Hollydene EMI Rest Home 46 York Road Southport Merseyside PR8 2AY Lead Inspector Mike Perry Unannounced 14th July 2005 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 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. Hollydene EMI Rest Home F03 F53 Hollydene EMI Rest Home S61914 V239373 14.07.05 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Hollydene EMI Rest Home Address 46 York Road Southport Merseyside PR8 2AY 01704 534539 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Hollydene Care Ltd Ms Helen Caul PC - Care Home Only 25 Category(ies) of DE (E) - Dementia - Over 65 - 25 Places registration, with number of places Hollydene EMI Rest Home F03 F53 Hollydene EMI Rest Home S61914 V239373 14.07.05 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person must at all times appoint a suitably qualified manager that is registered with the CSCI. Date of last inspection 16th February 2005 Brief Description of the Service: Hollydene is a residential care home that specialises in the care of older people with dementia. The home is reistered for caring for up to 25 residents. The home is a large old detached house to which more modern extensions have been added to the side and at the back. There is a large enclosed garden at the rear of the home; the garden to the front has been given over to off road parking. Hollydene provides permanent residential care for its residents. It does not provide nursing care. Hollydene is established in a residential area very close to Birkdale village and railway station. Southport town centre is about 1 mile. The registered manager is Helen Caul and the Registered Provider is Hollydene Care Ltd and the Responsible Person is Mr Tyfun Yilmaz. Hollydene EMI Rest Home F03 F53 Hollydene EMI Rest Home S61914 V239373 14.07.05 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over one day [6.5 hours in total]. It was an unannounced visit and was carried out as part of the regulatory requirement for care homes to be inspected at least twice a year. For this inspection a partial tour of the home was conducted. Care records and other care home records were inspected. The manager, deputy manager and 3 care/ ancillary staff were spoken to. Residents were spoken to and observations were made of their general condition. One visiting relative was interviewed. What the service does well: The manager caries out preadmission assessments on residents, which include liaising with health and social care professionals so that the admission to the home is suitable and care needs can be addressed appropriately. Following admission the support from health and social care professionals outside the home continues and appropriate support and referral is made depending on the needs of a resident. This was particularly so with one resident in the home who was having continued support from the Community Psychiatric Nurses as well as assessments in the past by a physiotherapist. There is good attention to ensuring that residents are dressed appropriately and standards are maintained around the personal hygiene of residents so that dignity is preserved. The relative spoken to on the inspection found it very easy to relate to the staff and felt that he was included in any decisions made. Staff were described as supportative and approachable. There is a good general atmosphere in the home, which is bright and homely. Residents are relaxed and staff interact well as part of the daily routine and take time to socialise, particularly in the afternoons. The manager ensures good recruitment standards so that staff employed are suitable and are checked appropriately in terms of past work record. There are also good training standards so that staff feel confident and supported to carry out their work and this is best evidenced by the fact that 11 of the 16 staff are trained to NVQ standard. Hollydene EMI Rest Home F03 F53 Hollydene EMI Rest Home S61914 V239373 14.07.05 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better: The care plans could be improved to be made more specific based around the needs assessed. Some care plans were very generalised and some of the ‘needs’ on the care plan were not particular relevant and tended to detract from the detail of other more relevant care needs. An example of this was an entry for one resident around breathing but this was not actually an issue whereas the poor sight this resident has was not really covered. The manager was very constructive in discussing this and intends to review and perhaps simplify the process so that all relevant car needs are addressed in more detail. Privacy and dignity of the residents is well attended to but the provision of screening in the shared bedrooms could be improved by a better use of curtains. The current curtains around washbasins do not allow for staff assistance and can compromise privacy. The requirements from previous inspections for the upgrading of the laundry and the provision of disabled access to the home remain although both are planned for the near future. Of more immediate priority is the provision of a liquid soap dispenser in the laundry so that staff can wash their hands properly. Hollydene EMI Rest Home F03 F53 Hollydene EMI Rest Home S61914 V239373 14.07.05 Stage 4.doc Version 1.40 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. Hollydene EMI Rest Home F03 F53 Hollydene EMI Rest Home S61914 V239373 14.07.05 Stage 4.doc Version 1.40 Page 8 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 Standards Statutory Requirements Identified During the Inspection Hollydene EMI Rest Home F03 F53 Hollydene EMI Rest Home S61914 V239373 14.07.05 Stage 4.doc Version 1.40 Page 9 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 standard(s) 3 [ standard 6 is not applicable for this home] The assessments carried out by the home are good and help ensure that the home can meet the needs of residents admitted. EVIDENCE: The Manager completes a preadmission assessment of each resident to help ensure that they are suitable to come into the home and that the home can meet their needs. The relative interviewed was pleased with the way this process had been managed and helpful guidance in the way of information guides had been supplied. The assessments seen were detailed and further assessments are completed once the resident is admitted a fuller assessment is completed covering all activities of daily living as well as mental state. There are also copies of care management assessments completed by social workers and health professionals. Hollydene EMI Rest Home F03 F53 Hollydene EMI Rest Home S61914 V239373 14.07.05 Stage 4.doc Version 1.40 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 standard(s) 7,8,9,10 All residents have a plan of care and these are drawn up with relative and resident involvement. Not all care needs are addressed however and the current format of the care plan means that needs are not addressed with enough detail. There is good liaison with health care support services so that residents are referred appropriately and health care needs are met. Care staff have a good understanding of the personal care needs of residents so that they are treated with respect and their privacy maintained although better screening in shared rooms would improve this for some residents. EVIDENCE: All residents have a care plan and senior staff in the home draw this up. Three residents were looked at in some detail and their care records were seen. There was evidence that care staff try to involve relatives and residents in the formulation of the care plans and this is more consistent than on the previous inspection. The relative spoken to felt involved and that information on care was passed to him when appropriate. The home try and get relatives involved in care plan reviews. The plans were rather vague in some instances and contained elements of car that were not really an issue for that individual. For example ‘breathing’ was Hollydene EMI Rest Home F03 F53 Hollydene EMI Rest Home S61914 V239373 14.07.05 Stage 4.doc Version 1.40 Page 11 listed on care plans even though there was no problem or need to address. Listing care that is not relevant serves to detract from the detail that is important in the care plan and makes it more difficult to read for care staff and relatives. Not all care needs were included on the care plan. For example one resident who is registered blind did not have care needs in this area addressed on the plan. The manager had some constructive ideas as to how to address these issues. Care notes of residents contain good evidence of referral and attendance to health care support such as General Practice [GP], chiropody, opticians and audiology. One resident had had regular support from the Community Psychiatric Nurse [CPN] service since admission and has received an assessment by a physiotherapist around mobility needs. Other residents had been referred to local psychiatric services as needs dictate. One resident with diabetes receives daily input from the distinct nursing/ diabetic service. Policies and procedures are in place for the management of medicines in the home and staff who administer medicines are appropriately trained so that the procedure is safe. The medicines trolley is kept in the dining area and needs to be attached to the wall by a chain when not in use to maintain security. Residents seen were all appropriately dressed and clean/ well presented. Relative interviewed confirmed consistent standards in this area so that residents’ dignity can be maintained. Staff were observed to be polite and patient when interacting with residents and the relative spoken to said that staff were always approachable. The double bedrooms seen did have some screens around wash basins but the space behind these does not have sufficient room for staff to assist residents in washing and therefore privacy can be compromised. A curtain separating the beds in these rooms would be more practical and ensure privacy for residents. Hollydene EMI Rest Home F03 F53 Hollydene EMI Rest Home S61914 V239373 14.07.05 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,15 Activities are provided and continue to be developed in the home and assist in providing some quality of life for all residents. Arrangements to involve relatives in the home and in the care of residents are good so that relatives feel supported and in contact with events. Daily choices of meals are always available and nutritious meals and special diets are provided, to ensure residents received a wholesome balanced diet. EVIDENCE: Following a requirement on the last inspection the manager has sought to address the issue of the provision of activities for residents in the home. A designated member of the care team has drawn up a basic activities programme and this is now being implemented in a flexible manner. Care records show that some residents have social profiles and activity assessments but this is not consistent throughout. A newsletter is produced for both residents and relatives and this advertises and lists various activities as well as giving general news about the home. Residents have recently been involved in physical activity classes, local trips to Birkdale village, coffee mornings and a bring and buy stall, VE day celebrations in may and time spent in the garden. There is a trip advertised in the dining room for a theatre outing for some residents. These activities continue to be developed. Hollydene EMI Rest Home F03 F53 Hollydene EMI Rest Home S61914 V239373 14.07.05 Stage 4.doc Version 1.40 Page 13 The day space in the home is bright and relaxed and staff were observed to be interacting well with residents who appear to be relaxed and settled. Those residents spoken to felt relaxed n the home and some said that they enjoyed the surroundings. Dinnertime meal was sociable and well enjoyed by residents. Choice is available daily and as well as being advertised staff asked prior to serving for preferences as much as possible. The cook had a good understanding of special diets for 2 residents. Representatives from local churches attend twice a week and 2 residents leave the home to attend church. Hollydene EMI Rest Home F03 F53 Hollydene EMI Rest Home S61914 V239373 14.07.05 Stage 4.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 There is a complaints procedure in the home so that residents and relatives can feel that their concerns are listed to. The awareness of adult protection and abuse is good and policies ensure that residents are protected. EVIDENCE: The home has a complaints procedure and this is displayed in the hallway as well as in the information given to relatives and residents in the ‘service users guide’. A complaint book records any complaints and there have been none since the last inspection. Staff interviewed were aware of the complaints procedure. Relatives feel that the staff listen to their concerns. Policies and procedures around abuse and protection of residents are available in the home. Staff spoken to had a good understanding of various types of abuse and were able to give examples of what may constitute abuse. a training matrix in the office lists staff that have attended training in this area. The manager has completed 4 courses over the past few years. Hollydene EMI Rest Home F03 F53 Hollydene EMI Rest Home S61914 V239373 14.07.05 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,24,26 There has been no progress on the outstanding requirements from previous inspections regarding the laundry and disabled access although Hollydene is subject to ongoing maintenance and upgrading and is clean so that residents live in a safe environment that meets their needs. EVIDENCE: The two requirements from the previous inspection for the provision of a ramp for disabled access and for the upgrading of the laundry remain as requirements and the manager stated that both of these are planned to be addressed in September 2005. The laundry was seen and is now tidier and shelving has been provided for clothing. Cleaning is difficult due to the porous nature of the floors and walls. A more immediate need is for liquid soap to be provided for hand washing to ensure that residents / laundry staff are protected from any risk of cross infection. A tour of some of the rest of the home revealed that the standard of cleanliness is generally good with no malodorous smells apparent. There has Hollydene EMI Rest Home F03 F53 Hollydene EMI Rest Home S61914 V239373 14.07.05 Stage 4.doc Version 1.40 Page 16 been ongoing refurbishment and decorating of the home with new flooring in the dining area as well as some bedrooms decorated. The bedrooms seen were clean and well presented. Residents had helped chose colour schemes where necessary and all rooms were well personalised with residents personal belongings and ornaments and photographs. Hollydene EMI Rest Home F03 F53 Hollydene EMI Rest Home S61914 V239373 14.07.05 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29,30 Staffing is consistent in the home and provides enough minimum numbers to meet resident’s needs satisfactorily. A training programme is provided for staff so that they are equipped to carry out their role and meet general care needs of residents in a safe manner. The procedures for the recruitment of staff are thorough so that residents are protected. EVIDENCE: The requirement from the last inspection for more consistent staffing at the weekends has now been addressed and duty rotas confirm that for the current 20 residents there are always 4 care staff on duty during the day. The manager is in addition to these figures for at least 24 hours during the week. Ancillary support is in the kitchen, domestic duties and laundry. Staff files were seen for the last two people employed and were up to date with regard to all necessary checks and references including criminal records clearance. Staff have been given copies of the General Social Care Council [GSCC] Code of Conduct which outlines some care standards expected of all care staff and was a requirement of the last inspection. The manager organises training for staff. Ongoing training includes NVQ’s and 11 of the 16 care staff have NVQ or equivalent training. Care staff interviewed described the induction process in the home and this was very inclusive. The manager has arranged specific training in dementia care for some of the staff so that care can be planned more effectively for the residents. [A recommendation was made to access training material from the Alzheimer’s Hollydene EMI Rest Home F03 F53 Hollydene EMI Rest Home S61914 V239373 14.07.05 Stage 4.doc Version 1.40 Page 18 Disease Society] A training matrix on the office wall lists statutory training such as fire safety and manual handling. Relative interviewed felt confident in the staff’s ability and was positive in support saying that staff were approachable and willing to assist. Residents were relaxed in the presence of staff and the interactions observed were supportative [for example at meal times and during some activities]. Hollydene EMI Rest Home F03 F53 Hollydene EMI Rest Home S61914 V239373 14.07.05 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) standards not inspected Not inspected on this visit. EVIDENCE: Hollydene EMI Rest Home F03 F53 Hollydene EMI Rest Home S61914 V239373 14.07.05 Stage 4.doc Version 1.40 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x 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 x 15 3 COMPLAINTS AND PROTECTION 2 x x x x x x 2 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x x x x x Hollydene EMI Rest Home F03 F53 Hollydene EMI Rest Home S61914 V239373 14.07.05 Stage 4.doc Version 1.40 Page 21 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. 2. Standard 7 19 Regulation 15 23 Timescale for action All care needs for individual ongoing. residents must be addressed and review included on the care plan. 30.1.06 The registered person must carry 30.1.06 out an assssment for disabled access and action the provision of ramped access to the home [last requirment date 1.7.05 not met] The laundry must be upgraded 30.1.06 to provide non pourous flooring and walls for cleaning maintainance. [Last requirment date of 1.9.05 to be extended]. A liquid soap dispenser is needed 30.1.06 in the laundry for effective handwashing and reducing the risk of infection. Requirement 3. 26 13 4. 26 13 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 7 Good Practice Recommendations Care planning documention should be reviewed as discussed so that details can be made more relavent an individulalised. F03 F53 Hollydene EMI Rest Home S61914 V239373 14.07.05 Stage 4.doc Version 1.40 Page 22 Hollydene EMI Rest Home 2. 3. 9 10 The madicine trolly should be sucured to the wall by a chain when not in use. Serious consideration should be given to the provision of curtains in shared bedrooms as discussed to ensure priivacy for residents when performing personal care. Hollydene EMI Rest Home F03 F53 Hollydene EMI Rest Home S61914 V239373 14.07.05 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Burlington House, 2nd Floor, South Wing Crosby Road North Liverpool L22 0LG 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 Hollydene EMI Rest Home F03 F53 Hollydene EMI Rest Home S61914 V239373 14.07.05 Stage 4.doc Version 1.40 Page 24 - 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. 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