Inspection on 14/09/07 for Hollymere House General Nursing Home

This inspection was carried out on 14th September 2007.

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

Hollymere House General Nursing... 28/06/06

Hollymere House General Nursing... 24/10/05

Hollymere House General Nursing... 05/07/05

Hollymere House General Nursing... 11/10/04

Hollymere House General Nursing... 08/06/04

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Hollymere House General Nursing Home Crewe Road Haslington Crewe Cheshire CW1 5QZ Lead Inspector Wendy Smith Unannounced Inspection 10:15 14 September 2007 th 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 Hollymere House General Nursing Home DS0000018737.V342257.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. Hollymere House General Nursing Home DS0000018737.V342257.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hollymere House General Nursing Home Address Crewe Road Haslington Crewe Cheshire CW1 5QZ 01270 501861 01270 585043 hollymerehouse@schealthcare.co.uk www.schealthcare.co.uk Southern Cross Healthcare Services Limited 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) Joanne Farrell Care Home 48 Category(ies) of Old age, not falling within any other category registration, with number (48), Physical disability (2) of places Hollymere House General Nursing Home DS0000018737.V342257.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 48 service users to include:* Up to 48 service users in the category OP (old age not falling within any other category) * Up to 2 service users in the category PD (physical disability) aged between 60 and 64 years Date of last inspection 28th June 2006 Brief Description of the Service: Hollymere House is a modern two-storey property that was purpose built as a care home for older people. It is set in its own grounds, that are shared with the neighbouring Primrose House nursing home. The homes are in the Haslington area of Crewe, close to local amenities and within easy reach of Crewe town centre. The homes are owned by Southern Cross Healthcare Ltd. Hollymere House General Nursing Home DS0000018737.V342257.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit took place on 14th September 2007 and took five and a half hours. The home had 46 residents, all over 65 years of age, of whom 13 were receiving personal care and 33 nursing care. A tour of the building, including all communal areas and some bedrooms, was completed. A sample of records was looked at and time was spent in conversation with the manager, residents, and members of staff. Some of the information contained in this report is taken from the Annual Quality Assurance Assessment that was completed by the manager at the request of the Commission for Social Care Inspection. Prior to the visit, comment cards were provided for a number of residents, visitors, social workers and GPs to give their views of the home. What the service does well: All residents are assessed by a social worker and by the home manager before admission to ensure that their needs can be met. Care plans are completed to a good standard and provide evidence that the health needs of residents are met. The arrangements for handling medicines meet the required standard. Comments cards received from residents and relatives indicted that they are generally satisfied with all aspects of the home. Two activities organisers opportunities for residents. provide a variety of social and recreational Complaints are responded to appropriately and good records are kept to show that complaints have been taken seriously. The home is well managed by an experienced manager and the views of stakeholders are listened to. The health and safety of residents and staff are protected by company policies and procedures and by regular servicing and maintenance of equipment. Hollymere House General Nursing Home DS0000018737.V342257.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Hollymere House General Nursing Home DS0000018737.V342257.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 Hollymere House General Nursing Home DS0000018737.V342257.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): Standard 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People interested in coming to live at Hollymere House are assessed to determine whether the home can meet their needs. EVIDENCE: People interested in coming to live at Hollymere House are assessed by the manager or the deputy manager. Most new residents are admitted from hospital, some directly from their own home, and others from a community support centre in Crewe. A new resident had been admitted to the home the day before this visit. A very thorough pre-admission assessment had been recorded by the home manager. A full care plan was well in progress. Her husband was visiting and was discussing her care with the nurse in charge. He had been invited to stay and have lunch with his wife. Hollymere House General Nursing Home DS0000018737.V342257.R01.S.doc Version 5.2 Page 9 One resident, who had been admitted to the home earlier in 2007, has a dementing illness and was presenting problems in meeting her needs. It is questionable whether her admission to Hollymere House was appropriate, however there were specific reasons why this had happened. It was clear that the manager was taking appropriate action to address the situation, involving other professionals. Hollymere House General Nursing Home DS0000018737.V342257.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): Standards 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care needs of residents are met and this is recorded in their care plans. Medicines are well managed. EVIDENCE: Three care plans were looked at on the ground floor and three on the first floor. They had all been completed to a satisfactory standard. They contained risk assessments and good monthly reviews and daily records. The records of regular reviews held with the resident and relative were particularly good. A social worker commented that the documentation relating to her clients was all in order. Hollymere House General Nursing Home DS0000018737.V342257.R01.S.doc Version 5.2 Page 11 The home receives a weekly visit from a local GP. The GP made the following comments on a survey form: They show empathy and caring in their nursing. They respond well to an emergency and ask for help when required. They encourage clients to maintain their dignity and also to self care as much as possible. However the GP also feels that recent staff changes have adversely affected the standard of care. The care plans provided evidence that other healthcare professionals, including tissue viability nurse, continence advisor, dietician, chiropodist, optician, visit the home to provide support and advice as and when required. The storage of medicines, including controlled drugs, is satisfactory. The medicine administration record sheets were well completed with no missing signatures. One resident is able to self-medicate with some of his drugs. A risk assessment has been carried out, but it was not clear exactly what medicines he had been given to manage himself. Residents who are diabetic have their blood sugar level checked regularly, however it was unclear from the records how often this should be done for each person. Hollymere House General Nursing Home DS0000018737.V342257.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): Standards 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 able to exercise choices in daily living, and social and recreational opportunities are provided regularly for those who wish to participate. EVIDENCE: The home employs two part-time activities organisers. They are both very enthusiastic about their work, and work well together to provide a variety of different activities for residents. A fete was planned for the day after this visit. Residents have enjoyed several trips out over the summer. Two people go regularly to a local ‘Stroke Club’. Following a number of changes in personnel, the home now has a stable catering team. The manager is working closely with the head chef and the other staff to improve the variety of meals. A ‘nutmeg’ system has been introduced by Southern Cross Healthcare to monitor the nutritional content of the meals. A comment card received from a relative said that the food is good, but another said that they would like more variety. Hollymere House General Nursing Home DS0000018737.V342257.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected by the home’s complaints and adult protection policies and procedures. EVIDENCE: Southern Cross Healthcare has comprehensive policies and procedures dealing with complaints and with the protection of vulnerable people. The manager keeps a record of any complaints received. These are filed in a complaints folder, which includes details of how the complaint was investigated and addressed. All staff have completed training so that they are aware of how to recognise and report any suspected abuse. Hollymere House General Nursing Home DS0000018737.V342257.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 21, 25 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Most parts of the home are spacious and comfortable but there are some longstanding issues that have not been fully addressed. EVIDENCE: The home was purpose built and provides a high standard of accommodation in single en-suite bedrooms and with spacious lounge and dining areas. Cleanliness has improved since the appointment of a housekeeper. A new maintenance person was appointed in 2006 and he works closely with the maintenance person at Primrose House. The gardens were tidy and well tended. Hollymere House General Nursing Home DS0000018737.V342257.R01.S.doc Version 5.2 Page 15 Overall the building is maintained in good condition, however some improvements have been needed for a significant length of time and have not yet been addressed. A number of double-glazed window panels are blown and have been for several years. Some of the exterior woodwork needs repainting. The first floor overheats during summer months and portable fans are used to try and keep the corridors within a reasonable temperature. All of the baths are low level, and this is very difficult for staff when assisting residents with bathing. Since the last Commission for Social Care Inspection visit, extractor fans have been fitted in bathrooms, and a ceiling track hoist has been fitted in one of the bathrooms, so that residents who are unable to use the bath chair are now able to have a bath. Hollymere House General Nursing Home DS0000018737.V342257.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Enough qualified and experienced staff are provided to meet the needs of residents. EVIDENCE: At present there are some vacancies for care staff, and these are being covered by the home’s own staff working extra shifts or by agency staff. The manager has found a reliable agency that is usually able to send the same staff, who have got to know the residents. One of the nurses who has worked at the home for a long time is currently on maternity leave. The rota showed that staffing levels of two nurses and seven care staff during the day, one nurse and four care staff at night, are maintained. The aim is to have a senior carer on duty at all times, but at present there are not enough senior care staff to achieve this. Information provided by the manager in the annual quality assurance assessment indicated that nine care staff have national vocational qualification in care and four others are working towards a qualification. Hollymere House General Nursing Home DS0000018737.V342257.R01.S.doc Version 5.2 Page 17 The personnel files for three recently recruited staff were looked at. All had completed application forms and had a POVA first check and a criminal records bureau disclosure. For one of the staff, it was unclear who her last employer was and this should have been clarified. One reference did not come from the person named on the application form and this was not explained. There was evidence that new staff complete an induction training process during their first three months working at the home. The records showed that all staff were up to date in the training that is required to ensure the health and safety of residents. Hollymere House General Nursing Home DS0000018737.V342257.R01.S.doc Version 5.2 Page 18 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): Standards 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a qualified and experienced manager and quality monitoring systems ensure that the best interests of residents are promoted. EVIDENCE: A new manager was appointed in April 2007. She is a registered nurse and has significant previous experience in care home management. She has attained the Registered Manager Award and has been registered by the Commission for Social Care Inspection as manager of Hollymere House. A notice in the entrance area informs visitors that the manager holds a surgery one evening a week and is available to discuss any queries or issues. A meeting for residents and relatives was held the evening before this visit. Hollymere House General Nursing Home DS0000018737.V342257.R01.S.doc Version 5.2 Page 19 These meetings are held every eight weeks. There are also regular staff meetings. The operations manager visits the home at least once a month and makes a report as required by Regulation 26 of the Care Homes Regulations. A monthly home audit is carried out alternately by the manager and the operations manager. The medicines audit has improved and now shows compliance at 90 . The Commission for Social Care Inspection Annual Quality Assurance Assessment was completed very well by the manager, and showed that she has identified areas where she can make improvements and take the home forward. An administrator is employed to deal with day to day office work. The administrator has responsibility for looking after personal spending money in safekeeping for residents. Personal spending money deposited on behalf of residents is paid into a bank account and a small float is kept at the home for residents to use. Information provided by the manager showed that all plant and equipment in the home are serviced and maintained in good order. Fire records are maintained including details of regular fire drills and the names of staff attending. All of the required policies and procedures are provided by Southern Cross Healthcare. Hollymere House General Nursing Home DS0000018737.V342257.R01.S.doc Version 5.2 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 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 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 2 X X X 2 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Hollymere House General Nursing Home DS0000018737.V342257.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard OP19 OP19 OP21 OP25 Good Practice Recommendations Window panels should be replaced as needed. Some exterior woodwork needs re-painting. Replace low level baths with ones that are more suitable for staff to assist residents. Improve the ventilation of the first floor to prevent it becoming too hot for residents and staff during the summer. Hollymere House General Nursing Home DS0000018737.V342257.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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. Extracts may not be used or reproduced without the express permission of CSCI Hollymere House General Nursing Home DS0000018737.V342257.R01.S.doc Version 5.2 Page 23 - 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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