Inspection on 27/02/07 for Holme Lea

This inspection was carried out on 27th February 2007.

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 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 Lea 08/11/07

Holme Lea 14/12/05

Holme Lea 06/07/05

Holme Lea 06/03/05

Holme Lea 05/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

SignHealth

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

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

CARE HOMES FOR OLDER PEOPLE Holme Lea Astley Road Stalybridge Tameside SK15 1RA Lead Inspector Janet Ranson Unannounced Inspection 27th February 2007 09.30 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 Lea DS0000005571.V331346.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 Lea DS0000005571.V331346.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Holme Lea Address Astley Road Stalybridge Tameside SK15 1RA 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) 0161 338 5187 0161 304 0990 Meridian Healthcare Ltd Miss Elaine Bradley Care Home 48 Category(ies) of Dementia - over 65 years of age (18), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (5), Old age, not falling within any other category (18), Physical disability (1), Physical disability over 65 years of age (3), Sensory Impairment over 65 years of age (13) Holme Lea DS0000005571.V331346.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 18 OP up to 18 DE (E) up to 3 PD (E) up to 13 SI (E) and up to 5 MD (E) and 1 named individual PD. 6th November 2005 Date of last inspection Brief Description of the Service: Holme Lea is a purpose built, two-storey building in its own grounds. It offers accommodation to up to 48 older people in single bedrooms, many of which have en-suite facilities. Communal space consists of five lounges, three dining rooms and a patio area to the rear of the building. The building is situated in a residential area of Stalybridge, opposite Stamford Park, and is close to a main road offering public transport links to Stalybridge and Ashton Under Lyne. Car parking is shared with the adjacent home, Stamford Court. The home is run by Meridian Healthcare Limited, an organisation which operates several other care homes in Tameside. Fees for accommodation and care at the home range from £343.66p to £356.66p. All fees are subject to a financial assessment carried out by the placing authority. Additional charges are made for hairdressing and chiropody services, newspapers, personal toiletries and arranged trips. Holme Lea DS0000005571.V331346.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the key inspection, which included an unannounced site visit by one inspector. The site visit took place on 27th February 2007 and covered a period of seven hours from 9:30am until 4:30pm. During the inspection time was spent talking to residents, relatives and staff, and observing the home’s routine and staff interaction with residents. A total of four residents’ identified needs were looked at in detail. Individual details of their experiences and care were examined from the point of admission to their current care. The inspector looked around the building and a selection of residents’ records was examined, including records of care, medication records, assessments of need, review notes and menus. The inspector checked what the Commission had asked the home to do at the last inspection (November 2005) had been done. Questionnaires were left at the home for use by residents, their relatives and the staff to comment on the service. What the service does well: This is a good home that provides a safe, warm and clean environment for the residents and their visitors. The numbers and skill mix of the staff promotes the independence and well being of the residents. The residents are protected from employment and selection processes. potential abuse by the company’s There is a consistent group of staff who have access to good training and support from the managers. Service users spoken with expressed satisfaction with the care delivered, and were happy with the environment. Holme Lea DS0000005571.V331346.R01.S.doc Version 5.2 Page 6 Service users are asked what they think about the service and are included in making decisions about the environment generally as well as their personal bedrooms. 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. The summary of this inspection report can be made available in other formats on request. Holme Lea DS0000005571.V331346.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 Lea DS0000005571.V331346.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): 1 & 3 (standard 6, intermediate care is not provided at this home). Quality in this outcome area is good. Holme Lea provides appropriate information for prospective residents to help them make an informed choice of where to live. The home’s system of assessment reflects individual preferences and social requirements. This means that the home can be certain of meeting residents’ diverse needs. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: A copy of the home’s statement of purpose, the service user guide and the last two inspection reports were available to the residents and any visitors to the home. These documents, along with others appertaining to the company services and quality surveys, were readily available within a display unit located in the main foyer. Holme Lea DS0000005571.V331346.R01.S.doc Version 5.2 Page 9 Four care files chosen at random, were examined as part of the inspection. They contained individual care needs assessments carried out by a community based professional. The organisation has a process of assessing potential residents’ needs undertaken by a senior member of staff. Prospective residents and their relatives are also invited to visit the home so that they can meet other people and see the accommodation for themselves. By completing such an assessment, the home can be sure that individual needs can be met. Holme Lea DS0000005571.V331346.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. The arrangements and systems in place ensure that residents have their health and personal care needs met appropriately. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: A selection of residents’ files was examined. They included a resident who was recently admitted and a resident whose needs were changing. All had a written plan of care and risk assessment. The quality of plans and written risk assessments had improved from the previous inspection. However, it was not always immediately apparent due, in part, to the manner in which they were filed, which was the most current plan. Holme Lea DS0000005571.V331346.R01.S.doc Version 5.2 Page 11 One care plan stated the resident had diabetes controlled by tablet and diet, although further into the document the medical needs had changed to show the resident was now dependent on insulin. It is understood that the carers get a verbal ‘handover’ at the start of each shift where immediate changes to anyone’s care would be brought to the staff’s attention. A selection of medical administration records was examined as part of the inspection process. They were completed appropriately. The home uses a monitored dosage system in association with a local pharmacy. The storage of medication was secure and the method of administration was safe. All staff who are responsible for medication have undertaken the appropriate training courses. All the residents have single rooms, which they could lock if they wished. Observation and discussion confirmed that the residents were free to access their own rooms and any of the communal areas as they wished. Meals could also be taken in their own rooms. Residents spoken with expressed satisfaction with the care they received. It was apparent from discussion with both residents and staff that the values of dignity and respect were highly regarded and appreciated. Holme Lea DS0000005571.V331346.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. The choices offered to the residents meet with their requirements and enable them to exercise elements of control over their lives. The programme of activities suits the residents’ requirements for stimulation. Visitors are made to feel welcome and remain in contact with their relatives’ care. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: A list of forthcoming activities for the month was available in the main hallway. Two people are employed to provide activities on two separate days during the week. Trips out are also arranged. A resident who had recently chosen to live at Holme Lea said she particularly enjoyed the activities and the entertainers. She was proud of her fingernails that had been manicured and painted by her carer. Holme Lea DS0000005571.V331346.R01.S.doc Version 5.2 Page 13 One of the activities organisers also chairs the residents’ meetings that are a regular feature at the home. Minutes were available for inspection but not looked at this time. Local Christian churches provide pastoral care to those residents who have been identified as wanting this service. A list of Christian festivals and holy days was displayed in the hallway. The weekly menu was examined. The cook explained that the contents of the menus are discussed at the residents’ meetings and changes made accordingly. Changes are also made to reflect the seasons and festivities. The main meal is served at midday and there is an option available at each meal. The evening meal had a good selection of hot or cold options to choose from. The manager said that the residents particularly enjoyed an informal tea when they remained in the lounge areas to eat a buffet style meal. Visitors could be seen during the day visiting all parts of the home. A resident escorted his visitors to the front door and waved them off. One resident said she particularly looked forward to visits from her family. Holme Lea DS0000005571.V331346.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. The home has an accessible complaints system with evidence that residents feel that their views are listened to and acted upon. Staff knowledge and understanding of adult protection issues provides a safe environment to protect residents from abuse. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: The home has an appropriate complaints procedure, which is made available to the residents and relatives. It was also displayed in the main hallway. This documentation had been examined on previous inspections and was not looked at on this occasion. A resident who spoke with the inspector said she would speak to a person wearing a “purple dress” (carers wear this colour of uniform) if she was not happy about her situation. Since the last inspection the Commission had received one complaint. The complaint had been referred back to the organisation for them to investigate. The circumstances and outcomes had been appropriately addressed and recorded, and were available for inspection purposes. Holme Lea DS0000005571.V331346.R01.S.doc Version 5.2 Page 15 Cards from satisfied families were displayed in the manager’s office. contained messages of thanks and appreciation. They A resident who spoke with the inspector described how she had been worried about youths’ behaviour during the hours of darkness, close to where she had previously lived. She went on to say how she now felt safe in the home and secure in the knowledge that a carer would come to her if she rang the bell during the night. There have been no issues concerning safeguarding adults in this home. All staff have received the appropriate Protection of Vulnerable Adults training. When interviewed they confirmed this to be the case. Holme Lea DS0000005571.V331346.R01.S.doc Version 5.2 Page 16 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, 20 & 26 Quality in this outcome area is good. Improvements to the home will provide the residents and their visitors with a pleasant warm and welcoming environment, on completion. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: It was reported by the manager that communal areas in the home and some bedrooms are to undergo a major refurbishment. A large conservatory is to be built to increase the area in one lounge. It is anticipated that the building and decorating will greatly improve the environment for the residents. Holme Lea DS0000005571.V331346.R01.S.doc Version 5.2 Page 17 There is a display in the main hallway with the intended colours and textures for the redecoration and soft furnishings on each unit. Some visitors and residents were observed to be looking and commenting (favourably) at the samples on the board. This is a good way of keeping everyone involved in the changes. It was noted whilst looking round the home that it was well maintained and clean, there were no offensive odours. A resident who spoke with the inspector said this was the usual case. Further to this, she said, “I always have a clean bed and good food.” Aids and adaptations are installed within the home to enable the residents to remain as independent as possible. To one side of the home there is a large grassed area with level access from the communal areas and therefore accessible to residents. A random selection of residents’ bedrooms was looked at. Many of the rooms have been adapted to provide en-suite facilities. Where this has not been possible, adapted toilets and bathrooms are close to the rooms. It was reported that more en-suites are to be installed during the refurbishment. It was apparent that the residents are actively encouraged to personalise their rooms. In one case, this truly reflected the occupant’s personality. It was evident that those residents who are independently mobile were able to move around all areas of the home at will. Holme Lea DS0000005571.V331346.R01.S.doc Version 5.2 Page 18 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. The residents receive care from well-trained staff that responds to the residents and visitors in a respectful manner. The home’s recruitment policy and procedure provides protection to the residents from unsuitable staff being recruited. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: The staff rota was looked at on the last inspection. The manager confirmed there had been no changes to the staffing complement since this time and there were no staff vacancies. The staff, in discussion with the inspector, stated they felt the staffing levels were about right and reflected the residents’ needs at that time. One resident told the inspector the “girls run about a lot.” In addition to carers, the home employs dedicated kitchen, domestic and laundry staff, and a ‘handyman’. Holme Lea DS0000005571.V331346.R01.S.doc Version 5.2 Page 19 The staff who spoke with the inspector confirmed they had attended an induction programme and had completed all the health and safety (mandatory) training. They said they felt well supported in their role and were proud to say they worked at Holme Lea. Team meetings are arranged at regular intervals and the programme of formal supervision is well established. The organisation has robust recruitment and selection processes in place. The manager said the staff group was stable and there were no vacancies. A small number of staff confirmed to the inspector that when they applied for a job at the home they had: completed an application form, provided names of two referees, agreed to a check with the Criminal Records Bureau and made a declaration of medical fitness The organisation continues to be a committed to the National Vocational Qualification training scheme with a total of 90 of carers achieving level 2 in care practices. Further service specific courses are also arranged and there is an expectation that carers will attend. Carers spoken with confirmed they undertook appropriate training. Holme Lea DS0000005571.V331346.R01.S.doc Version 5.2 Page 20 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. The manager of the home has the skills, experience and qualifications to run the establishment. The residents’ financial interests are safeguarded. Systems are in place to protect the residents, their visitors and the staff’s health and safety. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: The registered manager is supported through the organisation by an operations director and in the home by a deputy manager and a team of senior carers. She has the skills, experience and qualifications to manage the home. Holme Lea DS0000005571.V331346.R01.S.doc Version 5.2 Page 21 Reports are maintained of Regulation 26 visits made to the home by the registered provider or their representative. The operations manager undertakes the visits on an unannounced basis. Other unannounced visits are carried out to check on the health and safety aspects in the home. A system of annual satisfaction questionnaires are in place to enable the residents and their relatives to improve or comment on their care. The results are made public and recommendations acted upon. The manager stated that the outcomes are shared with the residents during their meetings. Copies of the satisfaction report analysis were displayed in the hallway. For those residents who are no longer able to deal with their money, the home has a system to protect their financial interests. Small amounts of personal allowances are retained for safekeeping. Records with receipts covering all expenses are retained for auditing and inspection purposes. No hazards to health or safety were noted during the inspection. The health, safety and welfare is further ensured by the systems in place to report accidents and incidents. Holme Lea DS0000005571.V331346.R01.S.doc Version 5.2 Page 22 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 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 Lea DS0000005571.V331346.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action 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 OP7 OP12 Good Practice Recommendations The registered person should consider the layout of the care plans and other records to ensure that the most recent information is readily available. Details of all faiths and their respective celebrations should be displayed, not just those of Christian festivals. 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