Inspection on 07/06/05 for Holm Lodge

This inspection was carried out on 7th June 2005.

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

Other inspections for this house

Holm Lodge 06/09/06

Holm Lodge 27/10/05

Holm Lodge 15/03/05

Holm Lodge 26/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Holm Lodge Lewes Road Ringmer East Sussex BN8 5ES Lead Inspector Kev Whatley & Suni Choitai (Pharnacist Inspector) Unannounced 7 & 8 June 2005 10:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Holm Lodge H59-H10 S21139 Holm Lodge V221628 070605 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Holm Lodge Address Lewes Road Ringmer East Sussex BN8 5ES 01273 813393 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Sri Ratnasinkam Mrs June Woolley Care Home (PC) 14 Category(ies) of Old age, not falling within any other category registration, with number (OP) 14 of places Holm Lodge H59-H10 S21139 Holm Lodge V221628 070605 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1. That a maximum of fourteen (14) service users are to be accommodated. 2. That service users must be aged sixty-five (65) years and over on admission. Date of last inspection 15 March 2005 Brief Description of the Service: Holm Lodge is a large detached house set over two floors with a newly completed extension; this has subsequently increased accommodation space from nine to fourteen beds, whilst adding a further dinging room and lounge area. Resident bedroom accommodation comprises of fourteen single bedrooms all with en-suite facilities, located on the ground and first floor. On the ground floor are two lounges, two dining rooms, with small conservatories at the rear and extension side of the home. The first floor is accessible by a stair lift. Holm Lodge is situated off the main road in Ringmer, close to Lewes town, and within easy reach of local facilities. There is a car park at the front of the home, and a large garden at the rear. Holm Lodge H59-H10 S21139 Holm Lodge V221628 070605 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term ‘service user’ to describe those living in care home settings. For the purpose of this report those living at Holm Lodge will be referred to as ‘residents’. The unannounced inspection took place on a weekday in June and lasted for approximately five hours. At the time of the inspection the home was accommodating fourteen residents. The following day an unannounced pharmaceutical inspection was carried out by the CSCI pharmacist. The inspection included a tour of the premises and it’s facilities, with many residents also consenting for their bedrooms to be viewed. Approximately three residents were spoken with individually, whilst several others commented on their care during a group discussion. The manager, the proprietor, and two members of care staff were spoken with during the visit; whilst a chiropodist who was carrying out one of their regular surgeries, was also spoken with, as was a friend of a resident who was visiting at the time. Care staff were also observed carrying out their duties. Records and documentation inspected included: residents files, residents care plans, the homes complaints and accident books, and staff files, whilst various policies and procedures were also viewed. What the service does well: What has improved since the last inspection? The home ensure that all residents have completed and signed their terms and conditions of residency on admission to the home. The home have developed an information sheet for residents in relation to advocacy support and advice. The home ensure they follow a robust staff recruitment process. Holm Lodge H59-H10 S21139 Holm Lodge V221628 070605 Stage 4.doc Version 1.20 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Holm Lodge H59-H10 S21139 Holm Lodge V221628 070605 Stage 4.doc Version 1.20 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Holm Lodge H59-H10 S21139 Holm Lodge V221628 070605 Stage 4.doc Version 1.20 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2, 3, 4, and 5. The home ensures that the needs of prospective residents are assessed prior to being admitted to the home, whilst involving relatives and carers in the admission process. EVIDENCE: A number of resident files were viewed and these confirmed that relevant pre admission information is obtained from such sources as: social services, G.P’s, and relatives. Files contained pre admission information and professional assessments of the psychological, mental health, and health care needs of residents. Evidence was seen of pre-admission questionnaires being used by the home to inform their own needs assessments. Several residents stated that they had been visited by the manager of the home prior to being admitted. A number of terms and conditions of residency were viewed, these were found to contain necessary information including the basic services being offered, such as 24 hour personal care, and extra services that incur additional charges such as chiropody, hairdressing, and newspapers. Files were also seen to contain social services contracts where relevant. Holm Lodge H59-H10 S21139 Holm Lodge V221628 070605 Stage 4.doc Version 1.20 Page 9 The homes policy on admission states that residents move in initially on a four week trial basis to allow both the home a period of further assessment to confirm they can meet the needs of residents, whilst allowing the resident time to decide whether the home is suitable for them. A number of residents stated that they had been made aware of this policy prior to moving into the home. Holm Lodge H59-H10 S21139 Holm Lodge V221628 070605 Stage 4.doc Version 1.20 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 standard(s) 7, 8, 9, and 10. The home must ensure that the assessed needs of all residents are met through completed and accurate care planning documentation. Medicines are given as prescribed to residents, however improvements are needed in documented evidence on medicine administration; whilst the morning administration procedure has to be reviewed to minimise risk. EVIDENCE: All resident care plans were viewed and these were seen to contain relevant information relating to how care staff should meet the assessed needs of residents, including the physical, emotional, social and health care needs. Care plans contained risk assessments that addressed such areas as mobility and mental dexterity and awareness. However two newly admitted residents did not have completed care plans or risk assessments, with little evidence found of how the home will meet their needs. On arrival the padlock on the medicines cabinet was seen to be unlocked. The window adjacent to this cupboard [which is quite low and opens out onto the street] was open. There is an un-lagged hot water pipe in this cupboard. Written policies in relation to medicines consist of one sheet, which lists ‘do’s and don’ts’ and does not cover all aspects of medicine management in detail. The morning medicines for administration are prepared onto two trays into Holm Lodge H59-H10 S21139 Holm Lodge V221628 070605 Stage 4.doc Version 1.20 Page 11 pots and then taken around. The medicines arrive into the home in blister packs. The dates on the medicine administration record sheet do not tally with the actual date. A few gaps were noted on the Medicine Administration Records. Staff were seen to interact appropriately with residents, treating them with respect, courtesy, and care. Residents stated that care staff were ‘second to none’ and ‘very caring’. Holm Lodge H59-H10 S21139 Holm Lodge V221628 070605 Stage 4.doc Version 1.20 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 standard(s) 12, 13, and 14. Residents are supported to maintain contact with others outside of the home, whilst visitors are made to feel welcome. Residents have access to independent support and advice. The home need to develop it’s activities programme. EVIDENCE: Residents stated that they are encouraged to maintain contact with family and friends. Two visitors arrived at the home during the inspection and confirmed that they visit regularly. They noted that they are always made to feel welcome at the home and have been invited to join the resident they are visiting for lunch or dinner on a number of occasions. The visitors book confirmed that a number of residents receive regular guests. Since the last inspection the home have developed a resident information sheet which explains clearly that they have the choice to access independent support or advice outside of the home. The information sheet is well prepared and contains the contact details of the local branch of Age Concern. Several residents stated that they are supported to engage in their chosen religious observance. One resident attends their local church once a week, whilst the home facilitate services once every six weeks. The home have a number of board games, cards, and jigsaws, however no evidence was found of a regular activities programme being in place. Holm Lodge H59-H10 S21139 Holm Lodge V221628 070605 Stage 4.doc Version 1.20 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18. The home ensure that there are suitable policies and procedures in place to address residents views, concerns, and complaints. Residents are protected from the risk of harm, abuse, or neglect. EVIDENCE: The homes complaints book was viewed. This indicated that no complaints had been received by the home since the last inspection; CSCI have not received and complaints since the last inspection. The homes complaints policy clearly outlines the manner in which the home have to address any concerns or complaints, including the timescales by which any investigation has to be completed. The policy is clearly displayed in the home. A number of residents stated that should they have any concerns that they feel able to talk to either a member of care staff, the manager, or the proprietor. A number of staff files were viewed and these confirmed that all necessary requirements had been followed including gaining confirmation of Criminal Records Bureau (CRB) checks and references prior to staff commencing work at the home. Evidence was found of staff induction and training that included adult protection training and awareness. Care staff spoken to were able to express an understanding of adult protection issues and the manner in which procedures must be followed. Holm Lodge H59-H10 S21139 Holm Lodge V221628 070605 Stage 4.doc Version 1.20 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 24, 25, and 26. Residents live in a well maintained and homely environment. The home must ensure that all health and safety regulations and requirements are considered and addressed. EVIDENCE: Holm Lodge H59-H10 S21139 Holm Lodge V221628 070605 Stage 4.doc Version 1.20 Page 15 The homes environment was found to be well maintained, both inside and out, and decorated to a satisfactory standard. However the hot water tap in the communal toilet in the extension was not working, whilst a lock needs adding to the toilet door. A fire exit in the upstairs corridor was found to be obstructed by a piece of plywood. Residents have easy access to all areas of the home with a stairlift available for those requiring assistance to the upper floor. The recently built extension has added a further dining and lounge area, allowing residents a choice where they wish to dine and relax; whilst wooden decking has added outdoor space. The home is comfortable with a homely feel, whilst consideration has been taken to blend in the new building with rest of the existing home. All of the homes bedrooms have en-suite toilet facilities. There are two assisted baths for service users, one on each floor. There is a toilet facility near both the communal areas. The premises were found to be clean and free from offensive odours or smells. Records confirmed that fire safety equipment is maintained by a service contractor, whilst staff have attended fire safety training; confirmation of recent fire alarm checks were found, although it was unclear when the home had last carried out a fire drill. Holm Lodge H59-H10 S21139 Holm Lodge V221628 070605 Stage 4.doc Version 1.20 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, and 29. The home deploys suitable numbers of care staff to meet the assessed needs of residents. The home employs care staff who are competent, skilled, and caring. Residents are protected from harm by the homes recruitment policy. EVIDENCE: The staff rota indicated that there is a minimum of three care staff on duty during the daytime with a senior member of staff leading the shift. The manager is available to offer assistance most weekdays. At night the home deploy one ‘waking night’ member of care staff who is supported by another ‘sleep in’ member of care staff. The home also employs a fulltime cook and a domestic assistant. Care staff on duty at the time of the inspection were seen to be competent, knowledgeable, caring and respectful of residents. Staff files confirmed that many of the care staff employed at the home have previous experience within the care profession. All staff undertake an induction and training programme which addresses all relevant areas such as: the Protection of Vulnerable Adults, Safe Handling and Lifting, Medicine Administration and First Aid. One member of the care staff has obtained the National Vocational Qualification (NVQ) level 3 qualification in Care, whilst another three members of care staff are currently undertaking their NVQ level 2 award. Records also confirmed that following the previous inspection, whereby an immediate requirement was made in respect of an error found in the homes recruiting process, that the home acted swiftly in removing a member of care Holm Lodge H59-H10 S21139 Holm Lodge V221628 070605 Stage 4.doc Version 1.20 Page 17 staff from working at the home until all the necessary recruitment checks had been confirmed. No new staff have been employed since the last inspection. Holm Lodge H59-H10 S21139 Holm Lodge V221628 070605 Stage 4.doc Version 1.20 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 36, and 38. The manner in which the home is managed encourages openness, choice, and respect; whilst the rights of residents are protected. The manager must review the formal supervision system and must ensure the health and safety of all at the home. EVIDENCE: Holm Lodge has been managed by Mrs Woolley for a considerable number of years. Mrs Woolley has considerable experience of offering care to vulnerable adults and commands a vast knowledge in relation to meeting the assessed needs of residents within the home. The manager has undertaken considerable care related training and is due to complete the NVQ level 4 award in Care Management. Both care staff and residents alike stated that they felt able to approach the manager should they have any problems, concerns or recommendations. The atmosphere in the home felt relaxed, homely and caring. Holm Lodge H59-H10 S21139 Holm Lodge V221628 070605 Stage 4.doc Version 1.20 Page 19 No evidence was found of care staff currently receiving formal supervision. Records maintained at the home, as required by registration, were legible, relevant, and concise, confidential information concerning staff and residents is stored in the office in lockable cabinets. In general the home is managed in a manner that ensures compliance with health and safety legislation. However as previously mentioned (see also standard 19), on the day of the inspection a fire exit was found to be obstructed. Holm Lodge H59-H10 S21139 Holm Lodge V221628 070605 Stage 4.doc Version 1.20 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. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 x COMPLAINTS AND PROTECTION 2 3 3 x x 3 3 3 STAFFING Standard No Score 27 3 28 2 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 x x 2 x 2 Holm Lodge H59-H10 S21139 Holm Lodge V221628 070605 Stage 4.doc Version 1.20 Page 21 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard OP7 OP9.1 Regulation 15(1) 13(2) Requirement The home must ensure that all residents have completed and up to date care plans. The home must develop their written policies in relation to all aspects of medicine management. That all records of medicine administration must be maintained accurately (outstanding from the previous inspection). The home must ensure that all medicines are stored securely at all times. That the home must develop a regular programme of activities. Timescale for action Immediate 30th August 2005 Immediate 3. OP9.3 13(2) 4. 5. 6. 7. OP9.4 OP12 OP36 OP19 & OP38 13(2) 16(2)(m) &(n) 17(2) 13(4)(a) Immediate 7th December 2005 That the home implements a 7th formal staff supervision December programme. 2005 That fire exit routes are kept free Immediate from obstructions and hazards at all times. Holm Lodge H59-H10 S21139 Holm Lodge V221628 070605 Stage 4.doc Version 1.20 Page 22 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 OP14 OP21 OP28 OP31 Good Practice Recommendations That the home should incorporate the information sheet regarding advocacy services into their statement of purpose/service user guide. That a lock should be fitted to the communal toilet in the extension area of the home. That 50 of care staff obtain NVQ level 2 in Care. That the manager completes her NVQ level 4 in Care Management. Holm Lodge H59-H10 S21139 Holm Lodge V221628 070605 Stage 4.doc Version 1.20 Page 23 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Holm Lodge H59-H10 S21139 Holm Lodge V221628 070605 Stage 4.doc Version 1.20 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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