Inspection on 15/09/08 for Holmers House

This inspection was carried out on 15th September 2008.

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

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

Other inspections for this house

Holmers House 16/06/09

Holmers House 24/06/08

Holmers House 27/06/07

Holmers House 21/08/06

Holmers House 20/12/05

Holmers House 14/09/05

Holmers House 25/01/05

Holmers House 03/08/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Random inspection report Care homes for older people Name: Address: Holmers House Holmers Farm Way Cressex Road High Wycombe Bucks HP12 4PU The quality rating for this care home is: The rating was made on: one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Geraldine Yates Date: 1 5 0 9 2 0 0 8 Information about the care home Name of care home: Address: Holmers House Holmers Farm Way Cressex Road High Wycombe Bucks HP12 4PU 01494 769560 01494 769566 alison.pulley@heritagecare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable): Type of registration: Number of places registered: Heritage Care Miss Alison Pulley care home 48 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability 0 0 0 Over 65 0 0 0 Conditions of registration: The maximum number of service users to be accommodated is 48. The registered person may provide the following category of service only:Care home personal care - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) Physical disability (PD) Old age- not falling within any other category (OP) Date of last inspection Brief description of the care home Homers House is a purpose built residential home, registered to provide care for up to 48 elderly persons within the category of old age and dementia type illness. Care Homes for Older People Page 2 of 11 The home is owned and managed by Heritage Care. Accommodation is provided in single rooms. The home is divided into smaller units, each with its own sitting room, dining room and kitchenette. There are safe accessible gardens to the rear and side of the property and car parking to the front. The home is situated in a residential area of High Wycombe, which has all the amenities of a large market town and has good commuter links. Public transport is accessible to the area. There are leisure facilities nearby and there is a large national department store and national chain supermarket in the same area as the home. Service users are registered with general (GP) practitioner practices and all service users have access to local national health services through GP referrals. Community Nurses visit the home and provide support to the home as needed. Care Homes for Older People Page 3 of 11 What we found: The reason for this visit was to undertake a specialist pharmacist inspection following concerns regarding the handling of medication that had been notified to The Commission for Social Care Inspection. We looked at the the medication records, storage and talk to care staff and the acting deputy manager. This home has had some problems in the safe handling of medication. Action is being taken to correct these and systems have been put in place to prevent problems in the future. People who use the service are given their medicines by care staff who have been trained in the safe handling of medicines and who have been assessed as competent to do so. Detailed written procedures are available to staff to provide additional guidance and to enable medicines to be handled consistently by all staff. No one was looking after their own medicines when we visited. This can be arranged if people wish to do this. When we visited there were two people who were having their medicines given to them covertly. For one of these there was a full multidisciplinary agreement in place for this to be done but this had not been completed by all parties for the second person. New procedures and documentation was being produced by the home to ensure that they get full agreement of all relevant people in the future. Clear records were being kept of the medicines given to people. These included the actual dose given if a dose range had been prescribed; the reason why a medicine was not given; details of where creams were to be applied. When it was necessary to make additional entries on the record charts supplied by the pharmacy these handwritten entries were signed for by the carer making the entry and they were checked for accuracy by a second carer. Medicines were stored securely for the protection of people who use the service. Additional storage and records were provided for Controlled Drugs to deter loss and readily detect any losses that might occur. What the care home does well: What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 4 of 11 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set. No. Standard Regulation Requirement Timescale for action 1 3 14 All sections of the preadmission form must be completed in full to ensure that important information about people using the service is not overlooked. 30/11/2007 2 7 15 The Registered Manager must ensure that care plans are accurately drawn up, effectively implemented and reviewed in order to meet residents needs. To ensure that care plans are based on an accurate assessment of the persons needs and support action to meet those needs. 31/08/2008 3 7 12 The Registered Manager must ensure that significant changes in residents health and welfare are fully recorded and acted on. To ensure that changes in residents health and welfare (such as weight loss) are properly investigated and acted on. 31/08/2008 4 7 15 People using the service care 30/11/2007 plans must be reviewed at least once a month to ensure that any changes in their Page 5 of 11 Care Homes for Older People care needs are reflected. 5 8 13 The Registered Manager 31/08/2008 must ensure that actions agreed at multi-agency meetings are acted on in the interests of residents health and welfare. To ensure that residents healthcare needs are met. 6 8 12(1) Nutritional and tissue viability assessments must be undertaken on admission and subsequently on a periodic basis to ensure that people using the service nutritional and skin integrity are regularly monitored. 30/11/2007 7 10 10 The Registered Manager 31/08/2008 must ensure that the privacy and dignity of residents is respected at all times. To protect the privacy and dignity of residents. 8 12 16(20(m) Details of people who use the 30/11/2007 service particular interests, hobbies and pastimes must be recorded in care plans to ensure that activities provided are appropriate to their needs and that they have the opportunity to pursue leisure interests. 9 12 16 The Registered Manager 30/09/2008 must review the programme of activities to ensure that it is appropriate to the needs of residents. So that a suitable range of Care Homes for Older People Page 6 of 11 activities is provided which meets residents needs. The manager should consult with other stakeholders in the home as necessary. 10 19 16 The Registered Manager 31/10/2008 must take appropriate action to ensure that the untoward odours noted in some parts of the home are eliminated. To provide a safe and pleasant environment for residents, staff and visitors. 11 26 16 It is a requirement that the 30/11/2007 manager must address the issues regarding the unpleasant odours within some areas of the home. If deemed appropriate to eradicate such odours carpeting and other flooring must be replaced. A suitable cleaning regime must be carried out in all areas of the home to ensure cleanliness throughout (previous timescale of 31/3/06 not met). 12 27 18 The Registered Manager is 30/09/2008 required to carry out a thorough review of staffing levels and staff skills using an appropriate and reliable methodology. A report of the exercise should be retained for future inspection. To ensure that there are sufficient numbers of appropriately trained and experienced staff to meet the needs of people living in the home. 13 29 Schedule 2 A recent photograph must be 30/11/2007 Page 7 of 11 Care Homes for Older People on all staff?s files to confirm proof of identification and to comply with current regulations 14 30 18 All staff must undertake dementia training to ensure that they are trained and skilled to meet the needs of people with dementia who use the service 30/11/2007 15 33 24 The Registered Manager is 31/08/2008 required to establish systems for reviewing the quality of care at regular intervals. A report of each review and of any corrective action taken shoukld be retained for inspection. To ensure that the care provided to residents fully meets their needs and that its quality is monitored by the Registered Persons. 16 38 38 The Registered Manager is 31/07/2008 required to ensure that all staff conform to good practice when handling food. To protect the health and welfare of residents and ensure that they are provided with food which has been stored in appropriate conditions. 17 38 23 The Registered Manager is 04/08/2008 required to ensure that the homes arrangements for fire safety are systematically implemented and adequate records maintained. To ensure the safety of Care Homes for Older People Page 8 of 11 residents, staff and visitors. Care Homes for Older People Page 9 of 11 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 10 of 11 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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