Inspection on 21/08/07 for Holme View

This inspection was carried out on 21st August 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 View 30/07/08

Holme View 30/08/06

Holme View 22/11/05

Holme View 18/01/05

Holme View 14/10/04

Holme View 17/03/04

Similar services:

Abbey The

Snydale Care Home

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Holme View Gillingham Green Holme Wood Bradford BD4 9DT Lead Inspector Karen Westhead Key Unannounced Inspection 21st August 2007 10:00 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 View DS0000033613.V340914.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 View DS0000033613.V340914.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Holme View Address Gillingham Green Holme Wood Bradford BD4 9DT 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) 01274 681682 01274 687205 City of Bradford Metropolitan District Council Department of Social Services Care Home 37 Category(ies) of Dementia (2), Dementia - over 65 years of age registration, with number (37), Old age, not falling within any other of places category (37) Holme View DS0000033613.V340914.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th August 2006 Brief Description of the Service: Holme View is owned by Bradford Metropolitan District Council and provides residential and day care. Day care is not registered with CSCI. Therefore only the home and the services provided were inspected. The home can provide care for up to thirty-seven residents. This includes residents who have some memory impairment. In the overall total, the home has ten rooms, which are used for people who need a short stay. Holme View is purpose built. It is in the Holmewood area, on the outskirts of Bradford city centre. There are a few local shops nearby. The home is split into four separate wings. All bedrooms are for single occupancy. There are digital locks fitted around the home and on all exit routes making sure residents cannot leave the building unless staff are aware and to make sure they are safe. The home is close to the city centre and the outlook from the rear of the building is open grassed area. There is a secure fence around the grounds of the home and there is a garden where residents can sit out. Staff in the home are supported in their work by other health care agencies, like district nurses and doctors. All laundry, including bedding and towels is dealt with on the premises. There are enough bathrooms, shower rooms and toilets for residents to use. Information provided by the home in respect of fees says that residents pay according to their financial assessment. Fees range from £94.43 a week (low rate) to £159.95 (medium rate) and £435.68 (highest rate). The fee does not cover the cost of newspapers, hairdressing, taxi fares or private chiropody treatments. Holme View DS0000033613.V340914.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was done by one inspector and had not been prearranged with the Manager. The inspector arrived at 10.00am and left at around 4.30pm. At the end of the visit, the manager was told how well the home was being run and what needed to be done to make sure the home meets the standards. The reason for the visit was to make sure the home was being run for the benefit and well being of the residents and in line with requirements. Before the inspection information received about the home was reviewed. This included the number of reported incidents and accidents, the action plan provided following the previous inspection and reports from other agencies such as the fire safety officer’s report. This information was used to plan the inspection visit. A number of records were looked at during the visit and all areas of the home were seen. The inspector met with staff and residents to find out what it was like to live and work at Holme View. One relative and three residents completed a survey to tell the inspector what the home was like. All their comments were positive. Direct quotes from the surveys are included in the body of the report. What the service does well: Residents can visit the home before they make a decision about moving in. The arrangements are flexible enough to make allowances for residents who need to move in quickly or may need longer to make a decision. Staff make sure residents have access to different leisure activities if they want by joining in with the day centre attached or providing entertainment in the home. Interpreters and advocates are available to residents and can be invited to meetings and reviews if necessary. Residents are helped to live their lives in a way they choose and staff promote residents’ individuality as far as possible. Examples of this were given, by resident’s comments and policies and procedures in place. The manager and staff on duty showed they have a good working knowledge of each resident’s needs. This was shown by the way they dealt with each resident, took time to listen and understand what the resident wanted and the way they explained to the inspector how they were able to meet the residents needs. However, some valuable work being done to meet residents’ needs is not being reflected in the records and some routines remain rigid despite senior staff trying to create a less institutionalised atmosphere for residents. Holme View DS0000033613.V340914.R01.S.doc Version 5.2 Page 6 Comments made by residents and visitors showed they were satisfied with the care provided and that staff were caring, friendly and attentive: • • • • • • • • • • • The home does everything you would expect of them. I came here for a short stay and decided to stop. I came here for a rest and stayed. Staff are good and always go and get me sweets and clothes. Staff do as they are told. Staff are helpful. I always like the meals; staff know I don’t like most meats. I really like the puddings here. I would write a letter of complaint and give it to one of the managers. I’m happy at Holmeview and have made many friends. The domestic staff keep the place clean and tidy. Staff said they liked working at the home. One group of staff said thought they worked as a team. Some staff said changes in the staff team had created some division in the whole group. What has improved since the last inspection? What they could do better: Care plans need to reflect the care being given. Additional work is also required to make sure staff know what to do in circumstances where residents are at risk. The monitoring and recording of residents’ weights needs to be improved and appropriate action needs to be taken if there is a change in weight. The provision of bins for kitchen and bathroom waste is not adequate. The current system is not hygienic. Specialist equipment such as bedrails are not being routinely checked. The staff toilet is out of order. Better signs are needed in the home to help residents find their way around independently. These need to be visible from the corridor so residents know where they are heading, the current signs are either flat on the doors or walls and residents looking down the corridor cannot see them. Holme View DS0000033613.V340914.R01.S.doc Version 5.2 Page 7 The extractor fan in the kitchen is dirty and needs a deep clean. The manager needs to produce a list of all the training staff have done over the last twelve months so that the level of input can be assessed. Efforts must continue to recruit to permanent posts to reduce the significant number of vacancies. There is no registered manager in the home. One must be appointed. The level of staff supervision is not satisfactory and needs to be organised on a regular basis. Two recommendations were made. Short stay residents do not routinely get a contract setting out the terms and conditions of their stay and they should. The deployment of staff organising activities needs looking at to make sure residents in the home are provided with enough stimulation. 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 View DS0000033613.V340914.R01.S.doc Version 5.2 Page 8 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 View DS0000033613.V340914.R01.S.doc Version 5.2 Page 9 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, 2, 3, 4 and 5. Standard 6 is not applicable. People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Residents and relatives get enough information before they decide to move into the home. A pre-admission assessment is carried out so that staff know what sort of care the resident needs and if they can meet that need. EVIDENCE: All residents and their relatives, if appropriate, are given a Statement of Purpose and Service User Guide. Residents are not admitted to the home without first being assessed and where possible, visiting the home to ask questions and get a ‘feel of the place’. If that is not possible, then relatives are invited to visit on the resident’s behalf. This gives the person moving in the opportunity to talk to other residents and spend time getting to know the staff and sample the food. The manager feels this is vital so that the resident can see if the home is suitable, that they have seen the room they will be moving into and see how the home is run. Holme View DS0000033613.V340914.R01.S.doc Version 5.2 Page 10 The Service User Guide gives an outline of what residents can expect. Whilst talking to residents, those who were able to recall moving in said they or their relative had been to the home before making the decision. Two residents said they had decided to move in permanently after only coming for a short stay initially. As part of the evidence gathering, four residents were case tracked. This involves looking closely at the residents plan of care, talking with the resident, observing staff practices to make sure the care needs of the resident are being met as recorded and talking to staff to make sure they have a clear understanding of what they are doing and why. The residents case tracked were chosen at random. Staff from the home carry out a pre-admission assessment of each resident’s needs before they are admitted. The pre-admission documentation used outlines a basic checklist of needs, and notes are made about where assistance or support will be needed. The information is then used to write a more comprehensive plan of care once the resident has moved in and staff have had time to get to know them. All the files seen contained sufficient pre admission information for the home to know the residents needs and make a decision to admit them for a trial period. At the point of admission, each permanent resident is given a contract that sets out the terms and conditions, the fees, and the room allocated. A sample of these were seen on residents files. It remains the case that short stay residents are not provided with a contract. This has again been highlighted as a recommendation. The home offers short stay placements for up to ten residents. The home also responds to those needing an emergency stay if they have a vacancy. In these circumstances they rely heavily on the information provided by the placing authority, usually a social worker. At times placements carried out on an emergency basis do not work out and historically staff have responded positively to these situations. Holme View DS0000033613.V340914.R01.S.doc Version 5.2 Page 11 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 and 10 People who use the service experience adequate quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Some plans of care are not clearly written so staff do not always know how to best care for each individual person. Further work is also needed to make sure all identified risks are adequately recorded and show what action needs to be taken to minimise risk. EVIDENCE: Senior staff are clear about what they need to do to meet the needs of the residents, however not all care plans reflected the comprehensive knowledge the staff team had about each resident. Additional work is also required to make sure staff know what to do in circumstances where residents are at risk. For example, where a resident is at risk of malnutrition or developing a pressure sore, records did not give full details of what action had been taken to minimise and monitor the risk. The standard of documentation seen varied a lot depending on who had been involved in creating the record. Holme View DS0000033613.V340914.R01.S.doc Version 5.2 Page 12 The management aims to involve residents and those who know them well in all aspects of their care if appropriate. This includes other professionals, family members and friends. It was clear when talking to the staff team that they were proactive in getting as much relevant information as possible to make the residents move as successful as possible but also to inform their long term care needs. Staff are aware of their skills but also their limitations and when necessary call other professionals in to assist. Case records showed regular and ongoing involvement from other agencies. Staff carried out their duties in a professional and competent way apart from two instances where the attention being given would have been more dignified had it been carried out in private or in a more discrete way. The medical administration record is well recorded by staff. Medicines are kept safe in a locked cabinet and only those staff trained to do so, give out medication. Residents have access to a wide range of NHS services via the usual referral processes. All residents are registered with a local doctor. Those admitted from out of the area are registered with one of three local practices. However the majority of residents are registered with the same doctor. If the resident has lived locally they keep their doctor if possible. Staff spoken to said they had a good relationship with the local doctors surgeries and valued the way in which residents were treated as individuals by the doctors. Residents are accompanied when attending outpatient appointments. Residents, who were able to comment, said they were able to please themselves and become involved as far as they wished with things in the home. Three residents said they followed their own routines and were given enough time alone if they wished. Different levels of engagement with staff were seen throughout the visit. In May 2007, CSCI were contacted for advise about what to do if a resident refused medication and whether it was right to hide medication in food or drink. This form of giving medication is ‘covert’. The pharmacy inspector was involved in the discussions and staff were given advise about the best practice in these instances. At the time of this visit none of the residents were refusing medication. There is a dedicated medical/treatment room in the home, which is used by the chiropodist and district nurses, as well as a storeroom for medication. Four care plans were viewed in detail. The information held, did not always match the resident it referred to. Residents who could not make their views known were observed interacting with staff during the visit. It was clear that staff knew the residents well enough to be able to understand what they needed and they responded to residents who seemed ‘lost’ or distressed in a caring and attentive way. Staff, Holme View DS0000033613.V340914.R01.S.doc Version 5.2 Page 13 although busy, did not pass residents without acknowledging them or engaging with them in some way. It was not clear from the records seen if all residents were being weighed regularly or if loss and increase in weight was used to trigger further investigation by the doctor or a dietician. There was no consistency with the units of weight being used, for example one entry would refer to the weight of a resident in stones and the next record would show kilos. This raises a question about how the weights were monitored and compared to show any loss or increase in weight. According to one record a resident had lost a significant amount of weight in 24 days but no action had been taken. A record is kept of all the incidents and accidents in the home. The manager could not explain how these are audited and although a record was being kept of frequency of falls the record was incomplete and did not show what action is taken, if any, where residents were falling on a regular basis. The manager and senior staff team are driving forward the rights of residents and trying to move away from custom and practice in the home, which is ‘old school’ and institutionalised. Some staff are dealing with this better than others. However, the manager has a plan of action to carry him and his staff team through the changes. Holme View DS0000033613.V340914.R01.S.doc Version 5.2 Page 14 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 and 15. People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Residents are satisfied with the planned activities. Food is good and meets the dietary and cultural needs of residents. EVIDENCE: Residents said meals were good and there was a variety of food available. The manager said the cook knew the residents well and knew what they liked to eat. This was reflected in the menu planning. A range of different tastes are catered for including diabetics and those needing a soft diet. Cultural and religious needs are also thought about and discussed when the menus are being planned. Residents are able to eat at different times of the day and this was seen during the visit. Those residents who may have difficulty in choosing a meal from a menu card or verbal prompts are shown the two meals being offered on the day so that can choose by looking at the meal and seeing which one they would prefer. Staff try to make sure there are age appropriate, educational and personal development activities available to all of the residents. Residents were seen taking part in meaningful activities, watching television, reading, chatting to Holme View DS0000033613.V340914.R01.S.doc Version 5.2 Page 15 one another or going out. There is a day centre attached to the home and residents are able to use this during the day. There are three activity organisers employed, however at the time of the visit there was only one working full time. The manager said this member of staff spent all her time in the day centre so if residents chose not to go to this area they relied on staff in the home to provide activities. This is an area, which needs careful review to make sure the deployment of staff is fairly distributed. The laundry at the home is not suitable for residents to use. It is also in an area only used by staff. The current group of residents are not required to deal with their own laundry. However, they are involved in keeping their own bedrooms clean and tidy if they are able and want to. Holme View DS0000033613.V340914.R01.S.doc Version 5.2 Page 16 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 and 18 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Residents are safe and protected from abuse. They are listened to and complaints are taken seriously. EVIDENCE: The complaints procedure is included in information given to residents and their relatives. On 3rd August 2007, a letter of complaint was received by CSCI and this was referred to the registered owner to investigate. The main points of the complaint involved the management of the home; staff using mobile telephones when assisting residents; that the home was smelly and dirty; lack of stimulation for residents and the high incidence of falls. The result of the investigation was not available during the visit as the timescale for a response was still valid. The home has an adult protection policy and has involved Bradford Adult Protection Unit when safeguarding incidents have occurred in the home. Staff were able to give a detailed account of what they would do if an allegation was made or there was evidence of suspected abuse or harm. Staff showed a good understanding of what signs to look for, especially if the resident was not able to voice concerns or communicate. Holme View DS0000033613.V340914.R01.S.doc Version 5.2 Page 17 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, 21, 22, 23, 24, 25 and 26 People who use the service experience adequate quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. The design and layout of the home meets the needs of residents. Work is still needed to make sure the home is safe and comfortable. EVIDENCE: The home is purpose built and meets the needs of the residents. As part of evidence gathering the manager had completed an assessment form for the home, which includes confirmation that all health and safety checks are done on equipment. Certificates are in place to show that the electrical hardwiring, gas, hoists and lifts are in safe working order. The home was clean and tidy. There was a slight odour in some areas, including individual bedrooms and communal areas, however this was said to be a marked improvement by visitors and residents. The home is working with a supplier and trying out a new cleaning product, which is designed to remove Holme View DS0000033613.V340914.R01.S.doc Version 5.2 Page 18 unpleasant odours from carpets and furnishings. This is expected to run for a few months. Staff are confident that the product will work. There is a call system, which residents can use to summon help from staff. Staff said the system worked well if residents understood how to use it. Otherwise checks are made on residents, when they were in their rooms. The system is old and some upgrading is planned. The smoking area used by residents is not ideal. The manager said an alternative area was being considered. Of the resident’s bedrooms seen, these seemed to reflect their choices and personalities. Rooms varied in style, some were personalised others less so. Some residents were happy to show the inspector their room. Some attention is needed to make sure the home meets national minimum standards. • Bins in the kitchens and bathrooms need lids to make sure hygiene standards are maintained. • Bedrails must be maintained and a record kept of the checks being carried out to minimise the risk of accidents and make sure they are properly fitted and in safe working order. • The staff toilet must be repaired. • Better signs are needed around the home to help residents find their way around independently. These need to be visible from the corridor so residents know where they are heading, the current signs are either flat on the doors or walls and residents looking down the corridor cannot see them. • The extractor fan in the kitchen is dirty and requires a thorough clean. The fence around the homes grounds provides good security and stops people from trespassing. The new conservatory area is nearly completed and staff are keen to see it finished so that residents can enjoy it. This will lead out onto the residents garden area, which is self contained with raised flowerbeds and seating areas. Holme View DS0000033613.V340914.R01.S.doc Version 5.2 Page 19 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 and 30 People who use the service experience adequate quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Residents are protected and supported by the staff recruitment procedure. However, additional staff are needed to fill the significant number of vacancies and staff need to be trained so that they can do their jobs properly. EVIDENCE: The record of staff training was not available so it was not possible to assess the training completed recently. According to staff on the day of the visit training had been intermittent and some staff said they needed to have training around moving and handling, food hygiene, first aid and fire safety. Staff training must be kept up to date and reflect good practice so that staff are skilled and have the abilities to do their job properly. The owner must now produce a list of the training undertaken over the last twelve months and a plan of future training so that the level of input can be assessed. Despite the significant number of staff vacancies staff must still be provided with appropriate training whether they are temporary or permanent. Four staff files were examined to see if the home carries out proper interview, recruitment and additional checks to make sure staff are suitable to work with vulnerable adults. Files contained all the necessary records. Some staff spoken to said Holme View was a nice place to work, they got on with the manager and senior staff and worked as a team to make sure the residents were Holme View DS0000033613.V340914.R01.S.doc Version 5.2 Page 20 content. One member of staff had worked at the home for twenty-three years. A minority of staff are still getting used to the new ways of working and were finding this a challenge at times. The duty rotas provided during the visit showed sufficient staff on duty at all times. Some staff talked about their commitment to their work and the way they could make a difference to people’s lives who live at Holme View. They talked about the guidance and leadership they had and about the shift handover arrangements. Staff morale was described by staff as ‘OK’ to ‘very good’. The residents said that they thought staff were good at their jobs. They referred to the manager and staff in positive terms. Many of them knew who staff were and felt they could talk to them if they had a problem. Relationships between staff and residents were generally good. The home has a busy atmosphere. However, staff did not attend to their duties without involving residents and giving time to check they were all right. Despite the busy atmosphere of the day there was a calm and homely feel in the home. The manager said he monitors staffing levels on a day-to-day basis and is able to authorise staff working additional hours when necessary. Nothing was observed during the inspection to suggest that current staffing levels are not adequate. There is a significant shortage of permanent staff. The owners have responded to this by releasing posts for advert and focusing on attracting applicants through a recruitment drive. Short listing was being done and the manager was confident they would be able to recruit to some of the eleven care assistant vacancies. At present the shortfall in hours is being covered by existing staff in the home on overtime or agency staff. Holme View DS0000033613.V340914.R01.S.doc Version 5.2 Page 21 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, 32, 33, 34, 35, 36, 37 and 38 People who use the service experience adequate quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. The temporary manager works closely with staff and residents and his experience and support from senior staff makes sure the home is well managed. EVIDENCE: The manager has relevant experience and skills to be able to run the home in a competent and effective manner. He is not registered with the CSCI and is the acting manager at present. The organisation must appoint a permanent manager. Holme View DS0000033613.V340914.R01.S.doc Version 5.2 Page 22 Resident’s finances are dealt with by a third party or relative where possible; otherwise the home employs a clerk who administers a small amount of cash on residents’ behalf. All transactions are covered by a receipt and recorded. The computerised system is backed up by a bound ledger and the amounts being held are cross-checked using a procedure which has safeguards in place to protect residents from potential financial abuse. The staff team try to put residents needs first and take pride in their work. They discuss day to day and care issues with the manager and area manager and find ways of overcoming problems relating to the care of residents. Staff and residents talked about the manager in a positive way and described his management approach and manner as firm, but open and friendly. They said he works with them; to make sure residents are being cared for properly. Staff supervision is not being done routinely. Supervisions are being done when there is a problem and is not being used as a developmental tool. The manager said this had been identified in his discussions with senior staff and plans were being made to make sure staff supervisions were scheduled every six to eight weeks. Rapport between residents and staff was friendly and appropriate. There was an element of banter, however, this was felt to be in accordance with the wishes of residents taking part, who later said they enjoyed the relationships they had with staff and felt included in the atmosphere of the home. The home has a health and safety policy which staff are familiar with. Fire alarms and emergency lighting are tested weekly and routine fire drills were being carried out. The inspector was told there were daily handovers between the morning, afternoon and night staff. On these occasions staff discuss each resident’s wellbeing and whereabouts and what the following shift has to cover. Holme View DS0000033613.V340914.R01.S.doc Version 5.2 Page 23 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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 2 3 3 2 3 3 3 2 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 3 3 2 3 3 Holme View DS0000033613.V340914.R01.S.doc Version 5.2 Page 24 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 OP7 Regulation 17(1)(a) Schedule 3 Requirement The registered person must make sure care plans reflect the care being given. Additional work is required to make sure staff know what to do in circumstances where residents are at risk. Residents’ weights must be monitored and recorded accurately. Appropriate action must be taken if there is a change in weight. 2 OP19 16 and 23 The registered person must make sure facilities in the home are adequate. Adequate bins must be provided for kitchen waste and soiled waste for hygiene purposes. Specialist equipment such as bedrails must be checked and maintained according to the manufacturers instructions. A record of the checks being made must be kept. The staff toilet must be repaired. Holme View DS0000033613.V340914.R01.S.doc Version 5.2 Page 25 Timescale for action 29/10/07 17/10/07 3 OP22 23 The registered person must provide signs in the home to help residents find their way around independently. These need to be visible from the corridor so residents know where they are heading, the current signs are either flat on the doors or walls and residents looking down the corridor cannot see them. The registered person must make sure the extractor fan in the kitchen is kept clean and is included on the cleaning schedule to prevent a build up of grease and dirt. The registered person must continue to recruit to permanent posts to reduce the significant number of vacancies. The registered person must produce an up to date list of the staff training for the last twelve months and a plan of future training so that the level of input can be assessed. The registered person must appoint and register a permanent manager for the home. The registered person must make sure there are systems in place for staff to be given one to one supervision on a regular basis. 20/12/07 4 OP26 23 19/10/07 5 OP27 18 20/12/07 6 OP30 18 29/10/07 7 OP31 8 20/12/07 8 OP36 18 29/10/07 Holme View DS0000033613.V340914.R01.S.doc Version 5.2 Page 26 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 OP2 Good Practice Recommendations The registered person should make sure that short stay residents are issued with a contract setting out the terms and conditions of their stay. The registered person should make sure the deployment of staff organising activities is adequate for those in the residential home. 2 OP12 Holme View DS0000033613.V340914.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 View DS0000033613.V340914.R01.S.doc Version 5.2 Page 28 - 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. 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