CARE HOME ADULTS 18-65
Hollystead 14 Old Mill Lane Liverpool Merseyside L15 8LN Lead Inspector
Christopher Bond Unannounced Inspection 26th November 2005 11.00 Hollystead DS0000025350.V269339.R01.S.doc Version 5.0 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 Hollystead DS0000025350.V269339.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 Adults 18-65. 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. Hollystead DS0000025350.V269339.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Hollystead Address 14 Old Mill Lane Liverpool Merseyside L15 8LN 0151 722 7874 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) Nugent Care Ms Bridget Lacey Care Home 16 Category(ies) of Learning disability (16) registration, with number of places Hollystead DS0000025350.V269339.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. Sixteen (16) LD (PC) and Five (5) PD (PC) within an overall total of 16 One (1) named SI person within the overall number of 16 One (1) named LD/E person within the overall number of 16 LD Date of last inspection 10th February 2005 Brief Description of the Service: Hollystead is a spacious Victorian house situated in the Liverpool 15 area of the city. It is set in its own extensive grounds and has off road parking facilities. The original building has been adapted to ensure that the facilities of the house and garden area are accessible and available to all service users. A unit has been added on the ground floor, which is ramped in order to give easy access to the main part of the house. Accommodation consists of: on the ground floor two lounges, central dining room and kitchen, in the basement there is a quiet room, an activities room and a light and sound room has been created which is nearly complete. There are sixteen single bedrooms, which are furnished to a high standard, and all have wash hand basins. The home currently has four bathrooms for use by service users that includes assisted bathing facilities. The house is centrally heated throughout. Hollystead was registered in November 2000 as a residential care home to provide permanent and respite care for a total of 16 adults with severe disabilities, some of whom also have physical disabilities. Hollystead DS0000025350.V269339.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place over four hours and commenced at 11.00am. Two of the residents were spoken to. The manager gave the inspector a tour of the home. Care records and staff records were also examined. What the service does well: What has improved since the last inspection?
There are good procedures to ensure that the service users medication is handled correctly which helps to ensure that they are safe. All of the care staff were trained by the organisation to do their jobs correctly. There had been several training events since the last inspection and the manager kept a list of who had completed specific training. Good training helps to ensure that residents are cared for well and that no one is put at risk. Most of the care staff had been trained in abuse awareness. Some of the rooms had been decorated and new flooring had been put down. Hollystead DS0000025350.V269339.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Hollystead DS0000025350.V269339.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hollystead DS0000025350.V269339.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 4 Thorough admittance procedures and careful assessment ensures that the home can meet people’s needs. Written information provided to prospective residents is good enabling an informed decision about admission to the home to be made. EVIDENCE: The manager had produced detailed illustrated information about Hollystead and the service that the home provides. Because of this, prospective residents and their families were able to see if the home was right for them before moving in. Nugent care had also produced a pamphlet that described what service new residents would receive. This was on display in the hallway of the home. There hadn’t been a new resident admitted to Hollystead for some time. Each resident had a detailed assessment that described his or her needs and abilities. This information is important because the home can then decide whether the residents needs can be met properly. Residents and their families could look round the home and stay there before making a decision about whether or not the home was right for them. Hollystead DS0000025350.V269339.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, and 9 The care plans were impersonal and did not reflect individual needs and aspirations as much as they should do. EVIDENCE: Each resident at Hollystead had a care plan that described their needs and how the home was addressing these needs. There was some good information written down about the residents and the care plans were reviewed so that changes could be made to the way people were cared for as their needs altered. It is important that this information is written down in a way that the residents can understand and is ‘Person Centred’, meaning that the resident has ownership of the plan. Goals and aspirations are identified and the care staff help them to achieve these. The home needs to adopt this way of caring for people and plans should be far more personalised and produced in a format that reflects the person’s interests and abilities. The plan should reflect the current needs, aspirations and goals of the resident, set out the services to be provided by the home to meet these needs and achieve goals, and develop the
Hollystead DS0000025350.V269339.R01.S.doc Version 5.0 Page 10 residents life as circumstances change. The individual plan is a yardstick for judging whether appropriate support is being given by the home. The residents had regular planned meetings to help them to make decisions about their lives within the home. The care plans also contained information about how decisions were made. Residents also went out into the community on a regular basis and were helped to take informed risks that would help their development and improve their skills. These risks were carefully documented and controlled. Hollystead DS0000025350.V269339.R01.S.doc Version 5.0 Page 11 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 15, and 16. Residents are given opportunities to use community facilities and resources to ensure community participation and widen their experiences. EVIDENCE: Care staff were seen talking respectfully to the residents. Privacy was respected and residents had the freedom to choose whether to be alone or not. No-ones personal mail was opened without permission. All of the bedrooms had locks on to help keep the rooms private. The manager confirmed that the residents went out intro the community the resources and facilities that are available for all to use. A lot of the residents were spending less time at the day service. It was also confirmed that residents did not go out in groups into the community and activities were enjoyed on an individual basis. The organisation had a caravan in Wales and residents were able to be supported to use this for holidays. Until recently the home had employed an activities coordinator to help develop peoples interests within the home. It was hoped that this post would soon be filled once again. The home had an activities room with instruments and art
Hollystead DS0000025350.V269339.R01.S.doc Version 5.0 Page 12 materials. There was also a ‘sensory’ room where residents could be stimulated through sight, touch and sound. Hollystead DS0000025350.V269339.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 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 and 20 Care staff give personal care appropriately and considerately. Well- trained care staff handle medication safely to ensure that residents are not put at risk. EVIDENCE: There were several residents within the home who needed help with personal care and there were good facilities within the home for helping to ensure that this was given appropriately. There were good procedures and policies in place to help to make sure that medication was given properly and that residents were not put at risk. There had been training for some of the care staff in medication awareness and the pharmacist visited the home to advise on the storage and handling of medication. Hollystead DS0000025350.V269339.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Good abuse training and procedures protected the residents. EVIDENCE: All of the care staff had attended training about abuse awareness since the last inspection. This helped to ensure that residents were safe and not put at risk. The manager had a good knowledge of the correct procedures to follow should abuse be suspected and Criminal Records Bureau checks and Protection of Vulnerable Adult checks were evident within the care staff files. There were good procedures in place to help protect residents from harm. The home had a complaints procedure on display in the hallway. It would be good practice to have an accessible complaints procedure for the residents to help to ensure they knew what to do if they were unhappy with the service that they received. This would involve using appropriate communication aids such as illustration or video. It would be helpful for care staff to be trained to assist residents to voice their concerns should they wish to do so. Hollystead DS0000025350.V269339.R01.S.doc Version 5.0 Page 15 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 28 and 30 Residents live in a homely, safe, comfortable environment. EVIDENCE: The home was relaxed, comfortable and safe. All of the residents that were spoken to said that they enjoyed living there. There were lots of personal possessions around in the residents’ rooms that reflected their personalities. The home was exceptionally clean and care was taken by the staff and residents to ensure that hygiene issues were addressed quickly and efficiently. The home was safe and secure. The lounge and dining areas were large and well furnished. This was a large home, which was unusual for people living in Learning Disability services. There were rooms set aside for residents to receive visitors and there was an activities and sensory room in the basement of the house. Some of the bedrooms had good views over the city. Hollystead DS0000025350.V269339.R01.S.doc Version 5.0 Page 16 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 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, 32, 33,34 and 36. Training provided by the organisation is regular and appropriate. Residents are protected by good recruitment practices. EVIDENCE: There were four care staff on duty during the inspection. A cook and a domestic staff member were also on duty. The home had employed new support workers over the past 12 months and the organisation had ensured that Criminal Records Bureau and Protection of Vulnerable Adult checks had taken place as part of their normal recruitment procedure. Several training events had taken place since the service was last inspected. New staff had gone through an induction programme. Core training in food hygiene, fire awareness; health and safety and infection control had taken place, which made the home safer for service users. Positive Intervention/ challenging behaviour training had taken place in order to provide a better facility for a resident who challenged the service. The care staff had also had training in Person Centred Planning and this would be useful when the transition is made to a more appropriate care planning system.
Hollystead DS0000025350.V269339.R01.S.doc Version 5.0 Page 17 Some of the care staff files did not contain a photograph of the staff member and this should be addressed as soon as possible. The registered manager recognised that 50 of support workers need to be trained to National Vocational Qualification (NVQ) level 2 by 31-12-05. Several of the staff members had achieved this qualification and others were working towards this. It is important that the value of using the Learning Disability Award Framework (LDAF) is recognised as a valuable tool for ensuring that support workers are properly trained to do their work. Care staff files showed that the staff were being supported to do their jobs correctly through individual meetings with the senior carers. It was acknowledged that this support was not as often as is recommended. Hollystead DS0000025350.V269339.R01.S.doc Version 5.0 Page 18 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 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: This section was not assessed during this inspection. Hollystead DS0000025350.V269339.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 Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 X 3 X Standard No 24 25 26 27 28 29 30
STAFFING Score 3 3 3 X 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 2 3 2 X 2 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Hollystead Score 3 X 3 X Standard No 37 38 39 40 41 42 43 Score X X X X X X X DS0000025350.V269339.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard YA32 YA36 Regulation 18 (1) (a) 12(5) Requirement 50 of care staff should have achieved NVQ level 2 by 2005. Support staff must be appropriately supervised on a regular basis. Timescale for action 31/12/05 31/01/06 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 Refer to Standard YA34 YA6 Good Practice Recommendations Staff records should contain a photograph of the person employed. The home should adopt a ‘Person Centred’ system of care planning to develop the individual skills and competences of service users. Hollystead DS0000025350.V269339.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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