CARE HOME ADULTS 18-65
Hollystead 14 Old Mill Lane Liverpool Merseyside L15 8LN Lead Inspector
Christopher Bond Unannounced Inspection 28th January 2006 10:30 Hollystead DS0000025350.V280757.R01.S.doc Version 5.1 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.V280757.R01.S.doc Version 5.1 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.V280757.R01.S.doc Version 5.1 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.V280757.R01.S.doc Version 5.1 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 26th November 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.V280757.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place over three hours. There were fourteen residents living within the home at the time of the inspection. There were also two people using the respite service. The inspector spoke to two residents and three of the care staff. The senior carer assisted the inspector and also gave a full tour of the home. Care records were examined, along with staff files, training records and safety certificates. What the service does well:
This home provides a stable and caring environment for its residents. The home was well furnished. The home was very clean and tidy. Care staff were pleasant and caring. The inspector saw that the residents were treated with respect and that their feelings were acknowledged and acted upon. There was lots of equipment around to help the care staff care for those who had a physical disability. The home had some good facilities available for the residents. There was an activities room, and a ‘sensory’ room where residents could relax with pleasant sounds and visual stimulation. The home was very spacious with lots of areas available for residents to be alone if they wished. The bedrooms were well furnished and some of the rooms had good views over the city. The grounds of the home were extensive and adaptations had been made to ensure that everyone could use the garden. The garden had a Gazebo where residents could sit out in good weather. Training provided by the company was regular and appropriate which meant that the care staff were better prepared to do their jobs. Hollystead DS0000025350.V280757.R01.S.doc Version 5.1 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.
Hollystead DS0000025350.V280757.R01.S.doc Version 5.1 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.V280757.R01.S.doc Version 5.1 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): EVIDENCE: This section was not assessed during this inspection. Hollystead DS0000025350.V280757.R01.S.doc Version 5.1 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, 8, 9 and 10. Care planning is improving to develop the residents’ lives and improve their care. EVIDENCE: There were plans to introduce a new form of individual plan where important information is written down to make sure that the residents are receiving the right type of care. The new plan was called ‘About Me’ and contained room for lots of detailed personal information and photographs. When this system of care planning is brought in for everyone it should mean that care planning and goal planning should be better. Care staff had been trained in Person Centred Planning and how it should benefit the residents. The new system should be introduced for all of the residents as soon as possible. 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.V280757.R01.S.doc Version 5.1 Page 10 Care staff were aware that information about the residents should be kept confidential. All of the personal files were kept safely in the office areas. Hollystead DS0000025350.V280757.R01.S.doc Version 5.1 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): 12, 13, 14 and 17 Facilities in the local community were used regularly to help residents have fuller and more active lives. EVIDENCE: The care staff described how residents were helped to access the facilities that were available in the local community. Residents went to the theatre quite regularly and shops, restaurants, cinemas, and other facilities were also used. The home had its own cook and the menu’s looked wholesome and appetising. One of the residents said that the food was ‘really nice’. The inspector saw that fresh fruit and vegetables were delivered and the food that was being prepared looked nutritious and tasty. The move toward Person Centred Planning will help the staff to develop peoples’ lives to a greater extent. Hollystead DS0000025350.V280757.R01.S.doc Version 5.1 Page 12 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, 19 and 20. Care staff give personal care appropriately and considerately. EVIDENCE: There was lots of special equipment available to help the staff care for those residents who were physically disabled. There were ceiling hoists and portable hoists to help care staff move residents safely and comfortably. There were also special bathing facilities. The care staff were very polite, and were seen talking respectfully to the residents. There was a nice atmosphere within the home and the residents looked happy with the way they were being cared for. One resident said that she really liked the staff and that they were always nice to her. It was good to see that one resident who had communication difficulties was being helped to voice her opinions. An individual communication assessment had been developed with the help of a speech therapist to help understand her needs and wishes. Hollystead DS0000025350.V280757.R01.S.doc Version 5.1 Page 13 Care staff were still receiving regular training in the administration of medication. All of the medication records were up-to –date and properly filled in. Hollystead DS0000025350.V280757.R01.S.doc Version 5.1 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): EVIDENCE: This section was not assessed during this inspection. Hollystead DS0000025350.V280757.R01.S.doc Version 5.1 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, 27, 29 and 30. Residents live in a homely, safe, comfortable environment. EVIDENCE: The home was relaxed, comfortable and safe. There were lots of personal possessions around in the residents’ rooms that reflected their personalities and particular interests. 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 fairly large and well furnished. Although the house was large, there was a conscious effort to ensure that the service did not become ‘institutionalised’. It is unusual for adults with a learning disability to be cared for in larger groups and the staff helped to ensure that the home remained pleasant and comfortable. It would be good practice, however, for the caring agency to consider housing people in smaller groups and in ‘ordinary’ houses.
Hollystead DS0000025350.V280757.R01.S.doc Version 5.1 Page 16 As described in the ‘Personal Healthcare and Support’ section of this report the home had quite a lot of specialist equipment to assist with the residents’ mobility. Some of the toilets had special aids, and there were walk -in showers and tilting baths. The home was very clean and there were no unpleasant smells. Hollystead DS0000025350.V280757.R01.S.doc Version 5.1 Page 17 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): 32, 34, 35 and 36 Care staff are being supported to be more effective in their role. Training is good which means that staff have the skills to be successful in their work. EVIDENCE: Nugent Care continued to provide good training to help ensure that the care staff were well prepared to do their jobs properly. Some of the care staff had registered for a nationally recognised qualification (National Vocational Qualification level 2 or 3). This will give them the skills to help them in their roles. Almost half of the total care staff group now have this qualification. Some of the care staff files did not contain a photograph of the staff member and this should be addressed as soon as possible. There were records to show that the care staff were being well supported by the management team. The manager had a list of when each of the staff had been supervised. Better support and advice for care staff means that they can be more effective in their role as support workers. Hollystead DS0000025350.V280757.R01.S.doc Version 5.1 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): 37, 38, 41, 42 and 43 Effective management and good safety training help to ensure that the residents are well looked after and safe. EVIDENCE: There had been lots of training in areas such as Health and Safety, Food Hygiene, Infection Control, Moving and Handling, Fire safety and First Aid. Such training helps to ensure that people are safe and not put at risk. Professional tradesmen had been employed to check all of the safety equipment, electrical equipment and gas appliances, lift services and the fire alarms. There were certificates to show that these had been properly inspected. The home was properly insured. All of these things help ensure the safety of the residents and staff. The residents’ finances were maintained properly and effectively. A well trained manager and management team ran the home well.
Hollystead DS0000025350.V280757.R01.S.doc Version 5.1 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 Standard No Score 1 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 X 29 3 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 X 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 X 3 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 X 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 X X 3 3 3 Hollystead DS0000025350.V280757.R01.S.doc Version 5.1 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. 1. Standard YA32 Regulation 18 (1) (a) Requirement 50 of care staff should have achieved National Vocational Qualification level 2 or 3. Timescale for action 30/04/06 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.V280757.R01.S.doc Version 5.1 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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