Inspection on 22/05/08 for Holme House

This inspection was carried out on 22nd May 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Holme House 08/05/09

Holme House 30/05/07

Holme House 19/06/06

Holme House 24/10/05

Holme House 07/06/05

Holme House 02/12/04

Holme House 18/05/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOMES FOR OLDER PEOPLE Holme House Oxford Road Gomersal Cleckheaton West Yorkshire BD19 4LA Lead Inspector Tony Brindle Key Unannounced Inspection 10:00 22nd May 2008 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 Holme House DS0000026273.V366291.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Holme House DS0000026273.V366291.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Holme House Address Oxford Road Gomersal Cleckheaton West Yorkshire BD19 4LA 01274 862021 01274 871702 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) Milelands Ltd Michelle Rathbone Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Holme House DS0000026273.V366291.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 40 To accommodate one named service user under 65 years of age - DE category 30th May 2007 2. 3. Date of last inspection Brief Description of the Service: Holme House is a care home registered to provide personal care and accommodation for up to forty, male and female, older people. It is situated in the Gomersal area of Kirklees fairly close to Birkenshaw, Birstall and the M62. The original property, which has been extended and modernised for its current use, retains some original features adding to its homely feel. There is ramped access to the front door of the home and stair lifts are in place to allow access to the ground and first floor. A passenger lift is also available. There are large, well-maintained gardens to the front and rear of the property where service users are able to sit when the weather permits. Car parking is available to the front of the property. The weekly fees in May 2008 range from £335.24 to £380.00 per week. Additional charges are made for hairdressing, newspapers and toiletries. Information about the home and the latest Commission for Social Care Inspection report are available from the home. The owner of Holme House is currently building a new care home on land at the rear of Holme House, and the registered manager explained that it is hoped that the new property will provide people with a more pleasant living environment for people. The registered manager said that it is the intention of the company that all the people living at Holme House will move into the new property once it is registered and ready for use. Holme House DS0000026273.V366291.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is two (2) stars. This means the people who use this service experience good quality outcomes. This unannounced visit started at 10.00am and ended at 3.00pm. This was a very positive and enjoyable visit. There was the opportunity to speak to people living at the home as well as the registered manager and care staff. The records of three people living at the home were seen and they included assessments, care plans, daily records and the record of activities. Five staff records were also seen and they included, application forms, references, police checks, training and supervision records. A sample of peoples’ medications and finances were checked and a look around the home was undertaken. Other information considered was the homes returned Annual Quality Assurance document and surveys that were returned Commission for Social Care Inspection. Survey feedback received was positive. The inspector would like to take the opportunity to thank the manager and her staff team for their hospitality and people using the service and their relatives for their patience and co-operation throughout the visit. What the service does well: There are good systems in place that are to be used to monitor the quality of the care provided by the staff. People’s financial interests are promoted by good systems, and the health and welfare of people living and working at the home are promoted. People’s needs are met by sufficient numbers of staff that are well trained. The home’s recruitment policies and procedures make sure that the correct checks are made on people wanting to work in the homes. The home is maintained and people like the décor and surroundings. The home is kept clean. People’s health and well being is promoted and protected by way of good policies and procedures for dealing with complaints or suspected abuse. People benefit from taking part in various activities based on their interests and hobbies, and are supported to access local community facilities. The meals provided at the home are of a good standard. Individual care needs are set out in individual care plans and people feel they are treated with respect. Holme House DS0000026273.V366291.R01.S.doc Version 5.2 Page 6 The home’s medication policies, procedures and practices promote and support the best interests and healthcare needs of the people living at the home. Each person considering moving to Holme House has their needs properly assessed, and is given information about the home by the manager, before admission. The admission process ensures that those new to the home know what to expect of the service from the outset. What has improved since the last inspection? What they could do better: The provision of appropriate carpet plates in some of the doorways would enhance the surroundings and help to prevent tripping hazards. Attention should be taken to ensure that people’s dignity is respected at all times. Staff should continue working towards achieving NVQ level 2 certificates. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Holme House DS0000026273.V366291.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Holme House DS0000026273.V366291.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3. The home doesn’t provide intermediate care. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each person considering moving to Holme House has their needs properly assessed, and is given information about the home by the manager, before admission. The admission process ensures that those new to the home know what to expect of the service from the outset. EVIDENCE: The registered manager described the admission process, stating that she visits each prospective new person to assess their needs. The records show that the registered manager considers the available information from a person’s social worker if they have one, talks to the prospective new person and their relatives. If the prospective new person is privately funded, the registered manager said that most of the information is gained through liaison with family members. This was supported by way of information held within people’s files. Records showed that a pre-admission assessment form used by the registered manager can be used to obtain information such as medication needs, physical health needs, allergies, eyesight and hearing problems, sleep Holme House DS0000026273.V366291.R01.S.doc Version 5.2 Page 9 patterns, mental health requirements and religious interests. One person living at the home said that the staff had helped them settle in very well and that they were given a lot of information about the home before moving in. The registered manager added that the new people and/or their relatives could visit the home at any time to have a look round, and added that new people are offered an introductory visit; may stay for a meal or come in for a full day to meet people. Another person living at the home confirmed this. The records show that during this time further assessments may take place if required. The registered manager added that new people are also given a copy of the home’s Statement of Purpose and Service Users’ Guide. Holme House DS0000026273.V366291.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7. 8. 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individual care needs are set out in individual care plans and people feel they are treated with respect, however, a lack of attention by staff in one instance means that for some, their dignity is not always upheld. The home’s medication policies, procedures and practices promote and support the best interests and healthcare needs of the people living at the home. EVIDENCE: Three care plans were looked at and were found to contain good levels of information such as a record of people’s assessed and identified health personal and social care needs, and a record of when the care plans are reviewed. It was noted that the level of information has improved since the last inspection when a requirement was made to ensure the care plans were detailed and kept under review. Further improvements were noted in that nutritional assessments are now available in the individuals’ care records, and there are systems in place to monitor people’s fluid and dietary needs. The registered manager explained that each person has a plan that has been agreed with themselves, or their relatives. The records confirmed this. One Holme House DS0000026273.V366291.R01.S.doc Version 5.2 Page 11 person living at the home said that they had been involved in telling the staff what their personal care needs were, and that the staff had been very good at meeting them. The records show that the health care needs of those people too frail to leave the home are managed by visits from local health care services. The care plans were seen to give an overview of people’s general health. Where a risk is identified, for example, falls care plans and risk assessments are in place giving details about how the risk is to be managed. The registered manager explained that some work has been undertaken to try and improve the ways in which the staff write the daily records. The records show that the daily records kept for individuals do reflect the level of care being provided and how each individual has spent their day. A sample of the medications held by the home were checked and these were found to be well maintained, with the records being completed correctly, the medication stored correctly and the quantities tallying with the records. The manager explained that staff working in the home receive medication training and information held within the training records confirmed this. A discussion with a staff member showed that they understood the procedures relating to medication, and was able to speak in detail about how medication is correctly booked in, stored and administered, and what to do if problems arise such as running out of stock. People living at the home spoke about how the staff speak to them in a kind and respectful manner and observations on the day showed that the staff take care to promote people’s dignity by the way they work with them in a person centered fashion. Examples of this included moving down to a person’s level to speak to them when they were sat in a chair, quietly talking to people about personal care issues, and ensuring that clear explanations are given to people about activities taking place in the home e.g. times of mealtimes and other events. However, on arriving at the home, one person living at the home was seen to be in a state of undress, and a staff member did not pick up on this, and allowed the inspector to walk past this person in order that they could sign in. This was pointed out to the registered manager who agreed that it was not good practice, and explained that the person in question does have a difficulty with their clothes and does undress from time to time. However, she agreed that appropriate action should have been taken to support the person with their dignity. She added that there is a care plan relating to this person, which details how the person is to be supported. The records confirmed there is an appropriate care plan in place. Holme House DS0000026273.V366291.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, .14 & 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People benefit from taking part in various activities based on their interests and hobbies, and are supported to access local community facilities. The meals provided at the home are of a good standard. EVIDENCE: Observation of care practices, and the way people are supported shows that the staff are flexible and attempt to provide a service that is individualized. People living in the home say that are spoken with as to how they would like to spend their time, and how they would like to be cared for. The manager explained that the staff help people to get involved in a number of activities such as card games, bingo, chair exercise and craft work. One service user who was spoken with explained that they really enjoy the activities and said that they like the variety on offer. Another person who had just returned from an outing with their relative said, “People do get the opportunity to go out for walks, visits to garden centres and sometimes even to the pub.” One visitor at the home said, “The manager and staff have open visiting arrangements,” and one person living at the home said, “I can entertain my Holme House DS0000026273.V366291.R01.S.doc Version 5.2 Page 13 family in my own room if I want instead of in the lounge with everybody watching.” The registered manager explained that unless there are legal reasons for people not to do so, they can carry out their own financial, legal and other personal business at a time that suits them. She added that people can decide who should know about, and have access to, their personal business. The records show that people can keep and control their money and their personal belongings, unless their individual circumstances mean that specific legal arrangements have been made. A check of the records and money held by the registered manager found no discrepancies. It is clear from visiting people’s bedrooms, that people are able to have personal possessions in their room. A person at the home said, “The food is of good quality, well presented and suits my needs. “. A look at the menus and food available on the day confirmed what the person had said. Holme House DS0000026273.V366291.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s health and well being is promoted and protected by way of good policies and procedures for dealing with complaints or suspected abuse. EVIDENCE: The records show that the service has a complaints procedure, which is available within the home, and its content was found to be satisfactory. Three people were spoken with who all said that they understood how to make a complaint and who to go to. The records show that complaints are recorded properly, and the right people are notified and spoken to at the right time. The policies and procedures regarding the safeguarding of people were found to be satisfactory. Within the policy there is clear information as to when incidents need external input and who to refer the incident to. Discussion with 2 staff members showed that they had an awareness of the content of the policy and would know what action to take if an incident took place, and who to refer any incident on to. A group of people living at the home said that they feel safe. The training records show that the staff team have received training in the area of safeguarding vulnerable adults from abuse. Holme House DS0000026273.V366291.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is maintained and people like the décor and surroundings, and the addition of a sluice facility is an improvement to the facilities within the building. However, the provision of appropriate carpet plates in some of the doorways would enhance the surroundings and help to prevent tripping hazards. People live in a clean home. EVIDENCE: As already mentioned within the summary of this report, the owner of Holme House is currently building a new care home on land at the rear of Holme House, and the registered manager explained that it is hoped that the new property will provide people with a more pleasant living environment, however, it was noted that the existing property provided people with a suitable living environment. Holme House DS0000026273.V366291.R01.S.doc Version 5.2 Page 16 At the last inspection, there were plans to add a suitable sluicing facility to the home, and this has now been done. A walk around the home found that in general it is well-maintained, however, a need to ensure that carpet plates are fitted to some of the door ways was pointed out as a potential tripping hazard and the registered manager said she would look into purchasing these. It was noted that the shared areas provide a choice of communal space for people, with opportunities for people to meet relatives and friends in privacy or in their own rooms. Two people living at the home said that there is a choice of bathing facilities, and that they liked the décor and surroundings. The records show that the management has a good infection control policy, and observations made on the day found this policy being put into practice, with staff members washing their hands after supporting people with personal care, and appropriate hand washing facilities available for visitors in the bathrooms. It was noted that due to a lack of storage facilities, the lounge area of the building felt quite cluttered due to the fact that activities equipment was being stored there. The registered manager said that she would look into finding alternative storage areas for the equipment so as to make the lounge a more pleasant environment. Holme House DS0000026273.V366291.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s needs are met by sufficient numbers of staff that are well trained and who are undertaking NVQ qualifications. The home’s recruitment policies and procedures make sure that the correct checks are made on people wanting to work in the home. EVIDENCE: Discussion with people living at the home showed that they have confidence in the staff that care for them. One person said, “ The staff really know what they are doing, they’re very kind and patient.” Another person said, “I used to live in a different home, and the staff weren’t as good as those here. I can talk to the staff here about anything, and they’ve always got time to listen.” The records show that the service clearly defines the roles and responsibilities of staff through accurate job descriptions and specifications. The rota showed that there is a satisfactory mix of qualified and unqualified staff working at the home, appropriate to the assessed needs of the people at the home. Two people living in the home said that they are confident that the staff providing their support and care have been well trained. The records show that a good level of training is offered to the staff team, and that staff without an NVQ II qualification are working towards achieving it. Holme House DS0000026273.V366291.R01.S.doc Version 5.2 Page 18 The personnel records show that two written references are obtained before appointing a member of staff, and any gaps in employment records are explored. The registered manager said that new staff are confirmed in post only following completion of a satisfactory CRB check, and satisfactory check of the Protection of Vulnerable Adults register. Information contained the personnel records confirmed this. Holme House DS0000026273.V366291.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31 33 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good systems in place that are to be used to monitor the quality of the care provided by the staff. People’s financial interests are promoted by good systems, and the health and welfare of people living and working at the home are promoted. EVIDENCE: The records show that the registered manager and staff make sure that so far as is reasonably practicable, the health, safety and welfare of people is promoted. Information contained within records held at the home shows that this is done by way of staff training, fire safety system testing, including emergency lighting, risk assessments and safety system monitoring. Staff explained that they take part in fire drills, and have received fire safety training, along with health and safety training. The records supported this. The Holme House DS0000026273.V366291.R01.S.doc Version 5.2 Page 20 records show that the home has insurance cover in place, with certificates on display. The systems relating to the safekeeping of people’s monies and valuables were found to be in good order. The staff said that they receive formal supervision, and the records confirmed this. The company has developed a quality assurance scheme that involves obtaining feedback from people at the home, their families and any visiting professionals. Once feedback is received, then a report on the quality of care will be published with an accompanying action plan (if required). Information held with the records at the home shows that monthly management visits take place by the service provider. Holme House DS0000026273.V366291.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 1 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Holme House DS0000026273.V366291.R01.S.doc Version 5.2 Page 22 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 Standard OP10 Regulation 12 4(a) Requirement People’s dignity must be upheld at all times. Timescale for action 01/07/08 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 OP28 Good Practice Recommendations Staff should continue working towards achieving NVQ level 2 certificates. Holme House DS0000026273.V366291.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Holme House DS0000026273.V366291.R01.S.doc Version 5.2 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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