Inspection on 06/07/05 for Holme Lea

This inspection was carried out on 6th July 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 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 27/02/07

Holme Lea 14/12/05

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 Steve Chick Announced 6 July 2005 th 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. Holme Lea F54 F04 5571 Holmelea v230843 060705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Holme Lea Address Astley Road, Stalybridge, Tameside, SK15 1RA 0161 338 5187 0161 304 0990 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) Tameside Care Limited Enterprise House, Grange Road South, Hyde, Cheshire, SK14 5NY Miss Elaine Bradley CRH Care Home 48 Category(ies) of DE(E) Dementia - over 65 Number 18 registration, with number MD(E) Mental Disorder -over 65 Number 5 of places OP Old Age Number 18 PD Physical Disability Number 1 PD(E) Physical Disability - over 65 Number 3 SI(E) Sensory Impairment over 65 Number 13 Holme Lea F54 F04 5571 Holmelea v230843 060705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 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. Date of last inspection 6th March 2005 Brief Description of the Service: Holme Lea is a large, two storey building in its own grounds, with ample car parking. It offers accommodation to up to 48 older people in single bedrooms. The home 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. Communal space consists of five lounges, three dining rooms and a patio area to the rear of the building. The home is run by Tameside Care Limited, a not for profit organisation which operates several other care homes in Tameside. Holme Lea F54 F04 5571 Holmelea v230843 060705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. During the inspection six service users were interviewed in private, as were three members of staff and one relative of a service user. Additionally discussions took place with the manager. The inspector also undertook a tour of the building and scrutinised a selection of service user and staff records as well as other documentation, including staff rotas, medication and maintenance records. Comment cards were received from one GP, four relatives and eight service users What the service does well: What has improved since the last inspection? Service user satisfaction with the provision of meals has significantly improved. Several areas of recording, including in connection with medication and demonstrating that service users are included in planning and review of their care needs, have improved. This helps to maintain an accountable service. Holme Lea F54 F04 5571 Holmelea v230843 060705 Stage 4.doc Version 1.40 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Holme Lea F54 F04 5571 Holmelea v230843 060705 Stage 4.doc Version 1.40 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 Holme Lea F54 F04 5571 Holmelea v230843 060705 Stage 4.doc Version 1.40 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) 1,2,3,4 and 5. Holme Lea provides appropriate information for prospective service users and provides written terms and conditions for each service user. Visits to the home before a decision is made to move in are encouraged, and the home ensures appropriate assessments are undertaken. EVIDENCE: The home has a statement of purpose and service user guide. These were not scrutinised at this inspection, but have been found to be appropriate on previous occasions. A random selection of service users’ files was inspected. Each had a copy of the homes terms and conditions which had either been signed by the service user or a representative of the service user. All files seen had a copy of an assessment undertaken by an appropriate community based professional. Some examples were seen where this assessment was complemented by the home’s own assessment. Holme Lea F54 F04 5571 Holmelea v230843 060705 Stage 4.doc Version 1.40 Page 9 The manager reported that a prospective service user would not be admitted unless she was confident that their needs could be met at Holme Lea. There was documentary evidence on the files seen that written confirmation of the home’s ability to meet their needs was given to service users. Visitors who were spoken to during the inspection confirmed that they were able to visit the home before their relative accepted a place there. Holme Lea does not offer intermediate care. Holme Lea F54 F04 5571 Holmelea v230843 060705 Stage 4.doc Version 1.40 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. Appropriate care planning is undertaken and service users have their health care needs met. Medication is appropriately stored and administered. Service users are treated with respect and dignity. EVIDENCE: A random selection of service users’ files was scrutinised. All had a copy of a care plan which had been signed either by the service user or a representative of theirs, signifying that they were in agreement with the plan of care. There was documentary evidence that the care plans were reviewed at appropriate intervals, and that any identified amendments were made to the plan. Daily records were generally maintained to an appropriate standard, although one example was seen where they did not clarify if an aspect of care identified in the care plan had been done or not. It was not clear if this was an administrative oversight or a failure to fully implement the care plan. The link between effective records and accountability was reiterated with the manager. Holme Lea F54 F04 5571 Holmelea v230843 060705 Stage 4.doc Version 1.40 Page 11 Most service user ‘comment cards’ returned reported that they liked being in the home and were well cared for. Relatives spoken to and comment cards returned confirmed that service users could be seen in privacy. Similarly the GP comment card confirmed that they could see their patients in private. Service users spoken to reported being treated with respect and dignity by the staff, whilst at the same time, one service user pointed out that “we have a bit of fun [with the staff]”. The records of contacts with medical and para medical personnel presented as being appropriately maintained. All service users and visitors spoken to expressed confidence in the home seeking appropriate medical support. One ‘comment card’ was received from a GP who made some negative observations about their perception of working in partnership with the home. However no evidence was found at this inspection to indicate this had a negative impact on the service users. Holme Lea used a pre dispensed monitored dosage system to administer service users’ medication. Medication was seen to be stored appropriately and medication administration records presented as being appropriately maintained. The GP comment card indicated that in their opinion medication was appropriately managed in the home. Holme Lea F54 F04 5571 Holmelea v230843 060705 Stage 4.doc Version 1.40 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) 13, 14 and 15. Service users are able to receive visitors at any reasonable time and can exercise choice and control over their lives within the context of communal living. Appropriate meals are provided offering some choice and ample portions. EVIDENCE: The home has a written policy promoting visiting at all reasonable times. All service users and visitors spoken to confirmed that there were no unreasonable restrictions on visiting. All relatives comment cards which were received confirmed that people were welcomed in the home at any time. All service users spoken to during the inspection confirmed that they could choose when to get up and go to bed, where to take their meals and where they spent their time during the day. The building is appropriately designed to enable service users to move as independently as possible throughout the building. Subject to health and safety considerations service users are free to leave the home. Holme Lea F54 F04 5571 Holmelea v230843 060705 Stage 4.doc Version 1.40 Page 13 Staff who were interviewed confirmed that service user choice and autonomy were valued at Holme Lea. One service user reported that “[you] can’t get better than here … you can do what you like.” The manager and staff have put considerable effort in to consultation with service users about the provision of meals. There was evidence of questionnaires for service users to complete as well as discussions in meetings with service users to address this issue. At this inspection the significant majority of service users consulted with were positive about the meals. One service user’s comment card reported that they did not like the food. Several service users commented that the food had improved significantly, putting this down to a new cook being employed. Meals sampled during the inspection were pleasantly presented and of good quality. The manager reported that there was an adequate food budget and service users confirmed an ample supply of food. Holme Lea F54 F04 5571 Holmelea v230843 060705 Stage 4.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18. Service users or their representatives are able to complain and complaints are dealt with appropriately. Service users are protected from abuse and exploitation. EVIDENCE: The home has an appropriate complaints procedure which is made available to service users and visitors. All but one service user comment cards indicated that service users knew who to talk to if they were unhappy with their care. All service users and visitors spoken to expressed confidence that any complaint would be dealt with appropriately. One service user, when asked about making any complaint, commented that “ they [staff] would want you to tell the truth [about any dissatisfaction]”. A record is kept of complaints which presented as being appropriately maintained. All service users spoken to expressed the view that they were safe at Holme Lea. One service user cited security and safety as being the best thing about the home. Holme Lea F54 F04 5571 Holmelea v230843 060705 Stage 4.doc Version 1.40 Page 15 Staff who were interviewed demonstrated an appropriate understanding of the need to be vigilant in connection with abuse, exploitation and poor practice. This was backed up by appropriate policies and procedures, within the home, including ‘whistle blowing’. Holme Lea F54 F04 5571 Holmelea v230843 060705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24, 25 and 26. Holme Lea is appropriately maintained and decorated throughout and provides appropriate personal and communal accommodation. Appropriate bathing and toilet facilities are provided. Service users can personalise their rooms. The home is clean and hygienic. EVIDENCE: A tour of the building was undertaken, including a random selection of service users’ bedrooms. The home presented as being well maintained and decorated throughout. No issues were identified which required remedial work to the building. Several communal areas were available for service users and visitors. One small lounge was designated as a smoking area. The rear of the building is a Holme Lea F54 F04 5571 Holmelea v230843 060705 Stage 4.doc Version 1.40 Page 17 patio area and lawned gardens. Appropriate garden furniture was present and service users were seen to be enjoying the sunshine. The home provides adequate toilet and bathing facilities, including aids and adaptations to assist people with restricted mobility. Service users who were asked expressed satisfaction with their bedrooms. All bedrooms are single, and observation and discussion with the manager confirmed that service users could personalise their room. During the inspection the home presented as clean and hygienic, with no unpleasant odours. Service users and visitors who were asked, confirmed that this was the usual state of the home. One service user reported that “… cleanliness means a lot to them [the staff]”. Holme Lea F54 F04 5571 Holmelea v230843 060705 Stage 4.doc Version 1.40 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 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, 29 and 30. Staffing levels are maintained to the minimum standard. Staff receive appropriate training to undertake their roles and are competent to do their jobs. The home’s recruitment procedures lack sufficient rigour. EVIDENCE: A staff rota was scrutinised which indicated that care staffing levels were maintained between six and seven staff in the morning (08:00 – 14:00) and between five and six staff in the afternoon / evening (14:00 – 20:00), with three staff from 20:00 to 08:00). This is an increase in staffing from the pervious inspection. Additionally the home has domestic and kitchen staff, a handyman and the manager. It was reported by the manager that staffing levels were subject to monitoring and review and could be amended if necessary. Many positive comments were received during the inspection process in connection with the individual staff members. However, no respondent to the relatives’ comment cards answered yes to the question “In your opinion are there always sufficient numbers of staff on duty?”. One expressed the view that “I think this [staffing] is a really big problem at times.” Holme Lea F54 F04 5571 Holmelea v230843 060705 Stage 4.doc Version 1.40 Page 19 Several service users who were spoken to identified staffing numbers as a problem and a visitor said the home was “great but short staffed”. The manager reported that of the twenty five care staff, ten had achieved NVQ II and five had NVQ III. A random selection of certificates was seen to verify this. It was also reported that seven more staff were registered on the NVQ II. Assuming they are successful and no one leaves, this will result in over 90 of the carers holding NVQ II or above. There was also evidence of an appropriate range of other training opportunities, which staff confirmed they were encouraged to participate in. These are all indicators of the company’s continued commitment to staff training. A selection of files relating to recently recruited staff was scrutinised. Whilst there was evidence that most of the necessary vetting of staff had been undertaken prior to them commencing work at Holme Lea, some areas of the process were not always sufficiently robust. One applicant had unexplained gaps in their employment history; not all CRB (criminal record bureau) disclosures appeared to have been received before the applicant started work; two CRB disclosures related to different care homes (although one was a home run by the same company) and in one case references held on file were not from the referees given on the application form. Failure to rigorously vet applicants before they start to work at the home could put service users at risk. Service users who were spoken to during the inspection were positive about the attitude and approach of the staff. Two service users described the staff as “very good”, one said “the staff are excellent … [they] give of themselves …[and are] very kind and helpful”. Another service user said “all you have to do is ask …”. One visitor cited the “friendly atmosphere” as one of the best things about the home. Holme Lea F54 F04 5571 Holmelea v230843 060705 Stage 4.doc Version 1.40 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 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) 35, 36 and 38. The home operates appropriate procedures to safeguard the financial interests of service users. Staff are appropriately supervised. The home maintains appropriate health and safety procedures. EVIDENCE: A selection of records relating to money held by the home on behalf of service users was scrutinised. They presented as being appropriately maintained, with a record of receipts and other practices to safeguard the service users’ financial interests. A selection of records relating to the supervision of care workers was seen. These, together with interviews with staff, confirmed that appropriate supervision was being offered. Holme Lea F54 F04 5571 Holmelea v230843 060705 Stage 4.doc Version 1.40 Page 21 A selection of maintenance and safety check records relating to mechanical equipment and fire protection procedures was examined. They presented as being appropriately maintained. Staff who were interviewed confirmed the availability and mandatory use of disposable gloves and aprons to minimise the risk of cross infection within the home. No issue of concern relating to health and safety procedures was observed during the inspection. Holme Lea F54 F04 5571 Holmelea v230843 060705 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 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 x 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 4 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x 3 3 x 3 Holme Lea F54 F04 5571 Holmelea v230843 060705 Stage 4.doc Version 1.40 Page 23 no 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. Standard 29 Regulation 19 (1) Requirement The registered person must ensure that no person is allowed to work at the home until the necessary vetting procedure has been completed. Timescale for action 31/10/05 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 7 27 Good Practice Recommendations The registered person should ensure that daily records reflect fully aspects of the care plan which have been undertaken. Given service users’ perception of inadequate staffing levels, the registered person should ensure that the appropriateness of the staffing numbers and deployment throughout the day is continually monitored. Particular emphasis should be placed on acertaining service users experience of staffing levels. Holme Lea F54 F04 5571 Holmelea v230843 060705 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection 2nd Floor, Heritage Wharf Portland Place Ashton under Lyne OL7 0QD 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 Holme Lea F54 F04 5571 Holmelea v230843 060705 Stage 4.doc Version 1.40 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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