CARE HOMES FOR OLDER PEOPLE
Hollygarth 80 Roman Road Linthorpe Middlesbrough TS5 5QE Lead Inspector
Christine Moon Unannounced 12 August 2005 10:00 am 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. Hollygarth B51-B01 S69 Hollygarth V244102 120805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Hollygarth Address 80 Roman Road Linthorpe Middlesbrough TS5 5QE 01642 821361 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) Mr G West Mrs S West Mrs Susan West Care Home 12 Category(ies) of OP Old age (12) registration, with number of places Hollygarth B51-B01 S69 Hollygarth V244102 120805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 12th November 2004 Brief Description of the Service: Hollygarth is a large, two storey detached Edwardian house situated in a residential area of Middlesbrough and which has been converted into a care home for 12 service users. Close to local amenities and accessible for public transport, the home stands in its own grounds which contain mature tress, providing privacy to the home itself, and an attractive outlook for service users. Accommodation is provided in eight single rooms and two double rooms. Communal areas consist of a large lounge, which is light and airy and has a view over the garden, and a smaller, second lounge which can accommodate service users who may wish to watch television. The dining room is at the back of the home, next to the kitchen, and this room can be used for activities. There is an enclosed patio area to the rear of the home, which is sheltered and which provides seating for service users when weather permits. A lift gives access to the upper floor. The home is comfortably furnished and residents are able to personalise their roooms according to choice and taste. Hollygarth B51-B01 S69 Hollygarth V244102 120805 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an Unannounced Inspection and took place over one day spent within the home, a total of almost 4 hours. The internal environment of the home was viewed and time was spent speaking with both service users, the Deputy Manager, service users and care staff. In addition, the Inspector had lunch with the residents and this was a valuable insight into an aspect of daily life within the home. A further Inspection of the home will take place within the 2005/2006 inspection year. What the service does well:
The manager, deputy manager and staff at Hollygarth are good at placing individual residents at the centre of all care provided. The home has a family feel about it, and one service user told the Inspector that she ‘likes the family atmosphere’. Another resident said that Hollygarth is ‘highly recommended’ and that she was ‘very happy’ there. Evidence gathered by way of both discussion and observation confirmed that there is an emphasis on social interaction and activities and that care is not just ‘task based’ but the provision of care is approached in a way which aims to enhance the quality of life of those living there. Members of staff also said they ‘love their work’ and this has resulted in a stable and consistent staff group, which benefits those being cared for. The environment of the home is very comfortable and in good decorative order and the proprietor/manager ensures that both maintenance and redecoration is carried out regularly. In addition the home is enhanced by the thoughtful touches of the manager, and tables with beautiful table linen, plants and flowers add to the homely and comfortable atmosphere at Hollygarth. Food prepared is of both high quality and nicely presented, and care is taken to ensure that mealtimes are an enjoyable and sociable time. Home cooking adds to the quality of food prepared for those living at the home. Hollygarth B51-B01 S69 Hollygarth V244102 120805 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? 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. Hollygarth B51-B01 S69 Hollygarth V244102 120805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Hollygarth B51-B01 S69 Hollygarth V244102 120805 Stage 4.doc Version 1.40 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 standard(s) These Standards were not assessed on this occasion EVIDENCE: Hollygarth B51-B01 S69 Hollygarth V244102 120805 Stage 4.doc Version 1.40 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8 and 10 Health, personal and social needs are set out in individual plans of care, and staff work with health professionals to try to ensure needs are fully met. Service users are definitely treated with respect at Hollygarth. EVIDENCE: Although all Care Plans were not examined in detail, it was seen that all living at Hollygarth have Care Plans and health, personal care and social needs are set out in these Plans. The Deputy Manager said that staff within the home are beginning to use Care Plans as day-to-day working documents, have been receiving instruction as to how information should be recorded therein and are taking responsibility for updating and recording on a day-to-day basis. Although a ‘key-worker’ system is in place within the home, being a small home of 12 residents, all staff have a detailed awareness of all personal care needs. In respect of health needs, the manager and deputy manager work with healthcare professionals, for example district nurses and general practitioners, in order to ensure health care needs are fully met as far as is possible.
Hollygarth B51-B01 S69 Hollygarth V244102 120805 Stage 4.doc Version 1.40 Page 10 Both observation at the time of the Inspection, and discussions with those who live at the home, confirmed that residents definitely feel treated with respect – staff were said to be ‘very nice people’ who ‘look after us well’. At all times during the Inspection, staff were seen to approach residents in a way which was both discreet and respectful. From the point of view of privacy, all personal care support is provided within individual rooms, or in the privacy of one of the bathrooms, when staff will always ensure that doors are closed. Hollygarth B51-B01 S69 Hollygarth V244102 120805 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14 and 15 The management and staff at Hollygarth try to ensure that all care needs are met, and that regular contact with family and friends is maintained. Service users feel they have choice in their daily lives. Food provided is both appealing, and nutritious and care is taken to ensure meal times are a pleasant experience. EVIDENCE: Both discussion with service users and observation on the day of the Inspection confirmed that those spoken with feel they have a good quality of life at Hollygarth. From a social perspective, residents who wish to are able to go out for walks, supported by staff, or take part in outings locally. Activities available include board games, reminiscence therapy, Scrabble, completing crossword puzzles. Some residents said that they enjoy listening to the radio, and watching television in the evening. Any service user who wishes to fulfil religious needs is able to be visited by clergy in the home, or is able to attend church services if they choose to do so. There is a policy of ‘open’ visiting, and during the Inspection it was observed that family and friends visiting the home appeared relaxed and at ease, and had a good rapport with staff.
Hollygarth B51-B01 S69 Hollygarth V244102 120805 Stage 4.doc Version 1.40 Page 12 All living at Hollygarth are able to make decisions as to how they will spend their day, with support from staff if needed. For example, service users are able to rise when they wish and breakfast late. A choice is available to either eat in the dining room, or in residents’ rooms if this is preferred. Service users can exercise choice as to whether or not they wish to remain within their rooms, or spend either all or part of their day in the sitting room or conservatory. During three years experience of inspecting Hollygarth, meals have been seen to be well prepared from fresh ingredients, attractively presented and appetising. Mealtimes at Hollygarth have been seen to be pleasurable events which residents look forward to. Tables are set with attractive table linen, and care is taken to serve meals in a way which recognises, in a discreet way, individual needs and wishes. The main meal of the day is served at mid-day; tea can also include a hot choice, for example soup, bacon sandwiches, if this is preferred. Fruit is available at any time and on the day of the Inspection, the sideboard contained a wide variety of fresh fruit which could be either accessed by residents or requested at any time during the day. Home-made cakes are available and are served with tea and coffee during the day. The quality of meals at Hollygarth and the careful preparation and presentation of these by staff is to be commended. Another nice touch is the fact that residents who previously enjoyed food from Marks and Spencer, can make requests and special items of food are purchased for them. Hollygarth B51-B01 S69 Hollygarth V244102 120805 Stage 4.doc Version 1.40 Page 13 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) These Standards were not assessed on this occasion EVIDENCE: Hollygarth B51-B01 S69 Hollygarth V244102 120805 Stage 4.doc Version 1.40 Page 14 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) 19,20,21,22,23,24,25 and 26 Hollygarth is comfortable and in good decorative order. Rooms are suited to the needs of residents, and communal space is both accessible, comfortable and pleasant. The home is very clean and hygienic. EVIDENCE: On the day of the Inspection, Hollygarth was seen to be well maintained and in good decorative order. Within the home communal space consists of a large sitting room, and a smaller sitting area, leading to a conservatory – both of which look out over the garden of the home. There is a dining room, which can be used for activities, and this room leads to the kitchen. Hollygarth stands in its own grounds, and as such there is attractive outdoor space which can be used, when weather permits, by those living in the home. Hollygarth B51-B01 S69 Hollygarth V244102 120805 Stage 4.doc Version 1.40 Page 15 Five of the ten bedrooms have en suite facilities consisting of a toilet and wash hand basin. Alongside this, there are toilets, which are easily accessible, on both the lower and upper floors of the home, as well as two bathrooms. By way of supportive equipment, a hoist is available if care needs indicate the need for this. All personal bedrooms were viewed and were seen to be very comfortably furnished. Two bedrooms are used as double rooms and in both cases those people currently using them are happy with the arrangement. Residents are able to personalise rooms with their own belongings, according to preference and taste. On the day of the Inspection, the home was seen to be very clean, tidy and hygienic. The manager and staff of the home are to be commended on the level of cleanliness – the home looked ‘spotless’. Hollygarth B51-B01 S69 Hollygarth V244102 120805 Stage 4.doc Version 1.40 Page 16 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) 30 Management within the home are working hard to ensure that staff are trained and competent to do their jobs. EVIDENCE: In respect of staff training, recent courses have included Infection Control and Fire Awareness, and in respect of fire safety training the Deputy Manager has completed an advanced level course which will enable her to train staff within the home. Safe Handling of Medicines training is to be undertaken within the home. In respect of the Protection of Vulnerable Adults, the Deputy Manager and one of the members of senior staff have completed this training, and the Deputy Manager said that she plans to raise the awareness of all staff in respect of issues around protection of vulnerable adults. Seven staff have completed NVQ Level 2 in care, which means that the home is on target in respect of having 50 of staff qualified to at least Level 2. The Deputy Manager will complete the Registered Manager’s Award in September of this year, and one member of staff will commence her NVQ Level 3 in Care. Formal Supervision of staff is undertaken by the Deputy Manager of the home. Hollygarth B51-B01 S69 Hollygarth V244102 120805 Stage 4.doc Version 1.40 Page 17 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) 31,32 and 33 Service users benefit from an ethos which places residents at the centre of all care provided and the home is definitely run in their best interests. EVIDENCE: The Proprietor/Registered Manager of the home is a Registered General Nurse, in addition to which she holds a UKCC Diploma covering management, health promotion and research. She also holds the 998 Teaching Certificate. She is aware that extra NVQ units need to be completed in order to achieve the equivalent of NVQ 4 in Management. The ethos within the home is one which comes from the standpoint of approaching care in a way which centres on each individual resident’s needs, putting the service user at the centre of the care assessment and thereby ensuring that, as far as is possible, needs are considered within an holistic framework. Hollygarth B51-B01 S69 Hollygarth V244102 120805 Stage 4.doc Version 1.40 Page 18 Observation, and discussion with staff and service users on the day of the Inspection confirmed that the home is definitely run in the best interests of those who live there. Staff spoken with had a high level of awareness of care needs, both physical and social, and staff work alongside other health professionals to try to ensure that, as far as is possible, all health needs are met. When necessary, general practitioners and district nurses visit the home. If the need arises, the registered manager has been seen to be prompt in requesting appropriate professional advice in order to ensure that issues are dealt with in an appropriate manner. Hollygarth B51-B01 S69 Hollygarth V244102 120805 Stage 4.doc Version 1.40 Page 19 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 N/A N/A N/A N/A N/A N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4
COMPLAINTS AND PROTECTION 3 4 3 3 3 3 3 4 STAFFING Standard No Score 27 N/A 28 N/A 29 N/A 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score N/A N/A N/A 2 3 4 x x x x x Hollygarth B51-B01 S69 Hollygarth V244102 120805 Stage 4.doc Version 1.40 Page 20 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 OP31 Regulation 9 Requirement The manager must undertake a course of study which equates with NVQ 4 in Management Timescale for action By 2008 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 Good Practice Recommendations Hollygarth B51-B01 S69 Hollygarth V244102 120805 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Unit B, Advance St Marks Court Teesdale, Stockton-on-Tees TS17 6QX 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 Hollygarth B51-B01 S69 Hollygarth V244102 120805 Stage 4.doc Version 1.40 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
