Inspection on 08/11/05 for Hollymount Nursing & Residential Care Home

This inspection was carried out on 8th November 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Hollymount Nursing & Residential... 07/09/06

Hollymount Nursing & Residential... 02/06/05

Hollymount Nursing & Residential... 13/01/05

Hollymount Nursing & Residential... 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 Hollymount Nursing & Residential Care Home 3 West Park Road Blackburn Lancashire BB2 6DE Lead Inspector Jane Craig Announced Inspection 8th November 2005 09:00 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 Hollymount Nursing & Residential Care Home DS0000022514.V256812.R01.S.doc Version 5.0 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. Hollymount Nursing & Residential Care Home DS0000022514.V256812.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Hollymount Nursing & Residential Care Home Address 3 West Park Road Blackburn Lancashire BB2 6DE 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) 01254 266450 01254 266451 Longfield Care Homes Limited Mrs Amanda Jane Walsh Care Home 38 Category(ies) of Old age, not falling within any other category registration, with number (38), Physical disability (25) of places Hollymount Nursing & Residential Care Home DS0000022514.V256812.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Within the overall total of 38, a maximum of 24 service users requiring nursing care who fall into the category of either OP or PD Within the overall total of 38, a maximum of 28 service users requiring personal care who fall into the category of OP Within the overall total of 38, a maximum of 1 service user requiring personal care who falls into the category of PD The Registered Provider must, at all times, employ a suitably qualified and experienced manager, who is registered with the National Care Standards Commission. 2nd June 2005 Date of last inspection Brief Description of the Service: Hollymount Nursing and Residential Home provides care for up to 38 people who have personal care or nursing care needs. The home is located in a residential area close to Corporation Park and approximately half a mile from Blackburn town centre. The main road with shops and other amenities is within walking distance. Hollymount is an extended detached property. It offers mainly single room accommodation with some en-suite facilities. Ample bathrooms and toilets are located close to bedrooms and communal areas. There are three lounges and a dining area. Decor and furnishings are of a good standard, comfortable and homely. Residents have access to well maintained gardens and a patio area. There are car parking spaces to the front and side of the home. Hollymount Nursing & Residential Care Home DS0000022514.V256812.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, which meant that the residents and staff were told beforehand when the inspector would be arriving. The inspection took place over one day. At the time there were 32 residents accommodated in the home. The inspector met with several residents and spent time observing interactions between staff and residents. Some residents were able to talk about their experiences of living in the home. Their views and comments form part of this report. The inspector also spoke with one visitor to the home. None of the comment cards sent to the home for residents and visitors to complete had been returned. Discussions were held with the registered manager and three other members of staff. A partial tour of the premises took place and a number of documents and records were viewed. Detailed notes were taken, which have been retained as evidence of the inspection findings. There had been one additional visit to the home since the last statutory inspection. The visit was in response to a complaint concerning early morning care practices, poor attitude of the night staff and roles of the night staff. Two elements of the complaint were not upheld. The concerns about the roles of the night staff were unresolved. What the service does well: Several residents said their health needs were well looked after at the home. They talked about staff making sure that they saw a nurse or doctor if they were not well. One resident said, “when I came here I couldn’t walk or talk and I was very depressed, they brought me to where I am today.” Residents spoken with were happy with the meals. Residents had plenty of choice at breakfast and teatime. One resident said, “we get well fed, the meals are great.” Another said, “the meals are smashing.” The registered manager made sure that new staff had thorough checks before they started work at the home. The home manager is competent and experienced. Residents and staff said she is approachable and supportive. Hollymount Nursing & Residential Care Home DS0000022514.V256812.R01.S.doc Version 5.0 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. Hollymount Nursing & Residential Care Home DS0000022514.V256812.R01.S.doc Version 5.0 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 Hollymount Nursing & Residential Care Home DS0000022514.V256812.R01.S.doc Version 5.0 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 the following standard(s): 2 and 3 Residents who were self funding were provided with sufficient information about the terms and conditions of the home. Other residents did not have easy access to important information. The pre-admission process ensured that staff that staff understood the resident’s needs and how they were to be met. EVIDENCE: Resident who funded their own care had signed contracts and copies were retained on their files. Other residents had individual service agreements with social services. There was a copy of the terms and conditions of residency available in the manager’s office. However, residents did not routinely receive copies of this on admission to the home. At the time of the inspection copies of the terms and conditions were being distributed to current residents. There had been an improvement in the quality of pre-admission assessments carried out by senior staff at the home. Three assessments were seen. They contained sufficient information to identify the needs of the prospective resident and to make a decision as to whether their needs could be met at the Hollymount Nursing & Residential Care Home DS0000022514.V256812.R01.S.doc Version 5.0 Page 9 home. One resident said she had met the manager before she came into Hollymount, which made it easier for her. Staff said the assessments were discussed with them before the resident was admitted and they were encouraged to read initial care plans. Hollymount Nursing & Residential Care Home DS0000022514.V256812.R01.S.doc Version 5.0 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 the following standard(s): 7, 8 and 9 Care plans were detailed but inaccurate or insufficient detail in progress notes and evaluations may result in care plans not being updated correctly. Staff met residents’ healthcare needs with support from other agencies. Risks to the health and safety of some residents were not always assessed or managed. Improvements in the management of medication provided safeguards for residents. EVIDENCE: Most care plans were detailed and provided staff with clear information about the type and level of support required to meet the needs of the residents. Initial care plans for new residents were prioritised in accordance with their assessed needs. Plans were reviewed every month. Some evaluations provided meaningful information about the resident’s progress; others were brief. Care plans showed evidence of amendments as the resident’s needs changed. However, out of date information was not always removed from the plans, which may cause confusion. There was a variance in quality of the daily progress notes. For example, two reports written on the day of the inspection did not include important information about the resident’s diet, which may have implications for evaluating care plans. Although residents and/or relatives were not routinely involved in drawing up or agreeing care plans, they Hollymount Nursing & Residential Care Home DS0000022514.V256812.R01.S.doc Version 5.0 Page 11 were invited to attend reviews of care every six months. One relative confirmed this and said that they were always contacted if there were any changes. Most plans contained risk assessments for moving and handling, falls, nutrition and pressure sore risk. Pressure sore prevention measures were recorded. Wound progress and treatment charts were up to date. One resident was unhappy about the way she was being moved. The manager was aware of this and was trying to address the situation. Some members of staff were seen to be moving residents without the use of a handling belt. One resident had bed rails in place but there was no risk assessment to support this practice. Plans showed that residents’ physical and psychological health care needs were monitored. Appropriate referrals were made to other professionals. Several residents said they were well looked after. One resident said, “when I came here I couldn’t walk or talk and I was very depressed, they brought me to where I am today.” A visitor to the home said that the staff were brilliant and her relative looked 10years younger since being at Hollymount. Following the last inspection three requirements and two recommendations were made to improve the way residents’ medication was managed. These had been implemented. The registered manager had put into place a safe system for disposal of unwanted medication. Hollymount Nursing & Residential Care Home DS0000022514.V256812.R01.S.doc Version 5.0 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 the following standard(s): 14 and 15 The amount of choice and control residents exercised over their life was dependent on their ability to make decisions. Residents received a well balanced diet. They were satisfied with the choice and quality of the meals served. EVIDENCE: Residents who were able to make their wishes and feelings known said they made choices and decisions about what happened in their daily life. One resident said, “I don’t know of any rules here.” Another resident talked about being able to go to bed and get up at anytime they wanted. Residents said they had specific days when they had a bath. Those spoken with were happy with the arrangement and said that they thought they would be able to change their days if they wanted to. Staff said they made decisions on behalf of residents who were not able to make their wishes known. One member of staff said they had to get to know the resident and talk to their relatives before they knew what their preferences were. They would then use that information to make choices for residents. Information about likes, dislikes and preferences were recorded on some plans. Records of menus showed that residents received a well balanced diet with fresh vegetables and fruit. The midday meal at the time of the inspection looked appetising. Residents’ comments about the meals were very positive. Hollymount Nursing & Residential Care Home DS0000022514.V256812.R01.S.doc Version 5.0 Page 13 They were satisfied with the variety, quality and quantity. Comments included; “meals are smashing,” “very good, different every day,” and “we get well fed, the meals are great.” There was a set meal at lunchtime. Residents were happy with this arrangement and said that if they did not like what was on they could ask for something different. There were several choices at breakfast and tea. Hollymount Nursing & Residential Care Home DS0000022514.V256812.R01.S.doc Version 5.0 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 the following standard(s): 18 Staff had a clear understanding of adult protection issues, which safeguarded residents and meant that any alleged incidents would be dealt with appropriately. EVIDENCE: Care staff received abuse awareness training within their induction programme. Two staff had received external training in protection of vulnerable adults and more places were scheduled. New local authority leaflets had been distributed to all staff. Following a previous recommendation protection issues were included on induction training for new or temporary nursing staff and they were made aware of the local procedure. Staff spoken with were aware of their roles and responsibilities in reporting alleged abuse. They understood the whistle blowing policy. The registered manager fully understood her role. Hollymount Nursing & Residential Care Home DS0000022514.V256812.R01.S.doc Version 5.0 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 the following standard(s): EVIDENCE: None of these standards were assessed. The key standards were assessed and met during the last inspection. Hollymount Nursing & Residential Care Home DS0000022514.V256812.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 29 and 30 Pre-employment checks were carried out, providing safeguards for residents. There had been improvements in the level of training offered to staff. However, persistent shortfalls in health and safety training may place residents at risk of harm or result in their needs not being met. EVIDENCE: The files of three staff were examined. All the required pre-employment checks were carried out before new employees commenced work at the home. The manager had a system for verifying the registration status of nursing staff. The required information and documents were retained on staff files, including evidence of training and qualifications. One overseas nurse had a work permit on file but this did not specify permission to work at Hollymount. The registered person must take advice from the Home Office with regard to the validity of work permits bearing details of other places of work. There had been improvements in staff training. The registered manager had altered the induction training programme but this needed further development to ensure it meets the current standards of the National Training Organisation and leads into the NVQ training programme. Staff said there had been more opportunities for training, including protection of vulnerable adults and dementia care. There was a programme of moving and handling and first aid training in progress. However, training in the other safe working practice topics was not up to date. Hollymount Nursing & Residential Care Home DS0000022514.V256812.R01.S.doc Version 5.0 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33 and 38 Residents and staff benefited from a well managed home. Systems were in place to measure and improve the quality of the service but these were not based on residents’ views. EVIDENCE: The registered manager, a registered nurse, had several years experience in senior positions. She had commenced training to NVQ level 4 in management. Staff and residents said the manager was approachable. Residents and relatives said they could go to her if they had any problems. Staff said she was supportive. The manager had some supernumerary hours to ensure time for management tasks. The home had retained the Blackburn with Darwen Quality Assurance Award. A development plan had been drawn up to address outstanding issues. Residents were invited to complete questionnaires about the service Hollymount Nursing & Residential Care Home DS0000022514.V256812.R01.S.doc Version 5.0 Page 18 approximately two weeks after their admission. Any suggestions for improvement were actioned by the manager. The surveys were not repeated but the results were published more than once. Discussions took place as to how the surveys could be conducted on a more regular basis to ensure the information reflected current views of all residents. Residents’ meetings were held. One resident said she had only attended one and it was very good. Another resident said “they ask if you have any complaints, you can say anything.” Residents’ relatives or representatives were invited to care reviews and their views and opinions were sought during this process. Two requirements to improve the health and safety of residents and staff had been made following the previous inspection. Both had been implemented. Hollymount Nursing & Residential Care Home DS0000022514.V256812.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 2 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 X X X X X X X X STAFFING Standard No Score 27 X 28 X 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X X X X 3 Hollymount Nursing & Residential Care Home DS0000022514.V256812.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? Yes 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 1 OP8 13(5) The registered person must 31/12/05 ensure a safe system for moving and handling all residents. 2 OP8 13(4) The registered person must 31/12/05 ensure that the use of bed rails is risk assessed and strategies drawn up to minimise risk. 3 OP29 19 The registered person must seek 30/11/05 advice from the Home Office with regard to the validity of work permits, which do not specify Hollymount as the permitted place of employment. 4 OP30 18 Staff must be provided with 28/02/06 updated training in all safe working practice topics. (Timescale of 08/06/04 not met) 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 OP2 Good Practice Recommendations All residents should be provided with terms and conditions of residency, within their service users guide. DS0000022514.V256812.R01.S.doc Version 5.0 Page 21 Hollymount Nursing & Residential Care Home 2 3 4 5 6 OP7 OP7 OP7 OP30 OP33 Out of date information should be removed from care plans. Residents and/or relatives should have opportunities to be involved in drawing up and agreeing initial care plans. Daily progress notes should provide an accurate reflection of the resident’s daily routine and care provided. The induction training programme should meet the current standards set by the National Training Organisation. The registered person should extend the resident satisfaction surveys to give all residents opportunities to make their current views about the home known. Hollymount Nursing & Residential Care Home DS0000022514.V256812.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Hollymount Nursing & Residential Care Home DS0000022514.V256812.R01.S.doc Version 5.0 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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