CARE HOMES FOR OLDER PEOPLE
Holmes House Care Home Kenilworth Road South Wigston Leicestershire LE18 4UF Lead Inspector
Chris Wroe Unannounced Inspection 7th February 2006 10:45 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 Holmes House Care Home DS0000058967.V282550.R01.S.doc Version 5.1 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. Holmes House Care Home DS0000058967.V282550.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Holmes House Care Home Address Kenilworth Road South Wigston Leicestershire LE18 4UF 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) 0116 2782214 0116 2789379 Collegia Care Ltd Linda Georgina Warren Care Home 48 Category(ies) of Dementia - over 65 years of age (25), Learning registration, with number disability (4), Mental disorder, excluding of places learning disability or dementia (6), Old age, not falling within any other category (48), Physical disability (10), Sensory impairment (4) Holmes House Care Home DS0000058967.V282550.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Category DE(E) No person falling within category DE(E) may be admitted to the home when 25 persons who fall within category DE(E) are already accommodated within the home. Category MD(E) No person falling within category MD(E) may be admitted to the home when 6 persons who fall within category MD(E) are already accommodated within the home. Category LD(E) No person falling within category LD(E) may be admitted to the home when 4 persons who fall within category LD(E) are already accommodated within the home. Category PD(E) No person falling within category PD(E) may be admitted to the home when 10 persons who fall within category PD(E) are already accommodated within the home. Category SI(E) No person falling within category SI(E) may be admitted to the home when 4 persons who fall within category SI(E) are already accommodated within the home. Service Users Service users between the ages of 55-65 years who fall within the above categories and were resident in the care home at the date of registration may continue to reside there. 2. 3. 4. 5. 6. Date of last inspection Brief Description of the Service: Holmes House Care Home is a care home offering accommodation for up to forty eight older people (over 65 years of age). The additional needs of people choosing to move to the home may include physical disabilities, mental disorders, dementia, sensory impairment and learning disabilities. The home is owned and managed by Collegia Care Limited. The home is located in South Wigston, approximately fifteen minutes by car from the Motorway (M1 and M69 junction). It is situated five minutes by car from the main high street in South Wigston, which has a range of local shops and facilities. The building itself is a modern purpose built property set in substantial grounds. The immediate area surrounding the home is a residential area. All areas of the home are accessible for people with limited mobility, and the home is equipped with a slow moving lift. There are grounds which residents can access. Parking is available to the front of the property.
Holmes House Care Home DS0000058967.V282550.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place on a weekday, 7th February 2006, starting at 10:45am and lasting for five hours. Lin Warren, manager of the home, was present during the inspection. The inspector spoke with fourteen residents during the inspection, all of whom gave positive views about the home. Comments made include: ‘I’m very happy living here’ ‘The staff are very good’. ‘They look after me very well. They make sure I can see a doctor if I need to’. The inspector also spoke with three relatives of residents, who were mainly extremely satisfied with the care given to residents. One relative commented that the home is ‘very, very, very, very good!’ and that staff are very considerate and sincere. One confidential issue of concern raised by one relative was discussed with the manager for her attention. The main method of inspection used was ‘case tracking’, which involved selecting four residents and tracking the care they receive through checking records, talking with the residents, talking to staff, looking round the home and observing care practices. At the last inspection, all of the key standards were checked. Some immediate requirements were made, but at a follow-up visit it was noted that all required actions had been carried out. At this inspection, the inspector looked at a number of aspects to ensure good care was continuing, such as care planning and medication. The following paragraphs relate only to aspects checked or raised with the inspector during this inspection: What the service does well:
Care plans give good information about the needs of residents and how their health and welfare is monitored. Staff show a good awareness of residents’ individual needs. Risk assessments are in place detailing how residents are enabled to be as independent as possible, but still kept safe. Holmes House Care Home DS0000058967.V282550.R01.S.doc Version 5.1 Page 6 Medication administration is good, with stocks kept safely, and records well maintained. There are a range of activities offered to residents, and residents confirmed that they enjoy taking part. Residents are able to see relatives and other visitors when they choose to, and to form friendships with each other. Staff have a good awareness of procedures relating to protection of vulnerable adults from abuse. Training has been given to staff, and further training is planned. All parts of the home seen during the inspection were found to be clean, tidy and hygienic. Staffing levels were sufficient at the time of inspection to meet the needs of residents. Staff undertake ongoing training in a range of areas, to help them to do their work well, for example first aid, food hygiene, moving and handling. A number of staff have undertaken National Vocational Qualifications in care. The registered manager also continues professional development, and has almost completed the Registered Managers Award. The manager and staff are commended for their commitment to ongoing training. Residents are enabled to give their views about the running of the home at residents’ meetings. Relatives are also invited to attend. What has improved since the last inspection?
At a follow-up visit, it was identified that all actions required at the last inspection had been carried out by the home. Improvements were therefore noted in medication administration, care planning, preparation of risk assessments, hygiene and cleanliness, and staff awareness of residents’ needs. A new falls prevention programme has been put in place, to attempt to minimise the number of falls residents experience. The owners, manager and staff are commended for this development. The home has set up a contract with a new pharmacist, which has improved medication systems in the home. Training has been provided for staff by the pharmacist. Holmes House Care Home DS0000058967.V282550.R01.S.doc Version 5.1 Page 7 Fresh (and cooked frozen) vegetables are offered at mealtimes now, to ensure residents get good nutrition. Fresh fruit is available for residents. Some areas of the home have been re-carpeted. A new staff room has been established, for the safekeeping of all files and documents relevant to staff, which enables information to be passed to staff more effectively. 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. Holmes House Care Home DS0000058967.V282550.R01.S.doc Version 5.1 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 Holmes House Care Home DS0000058967.V282550.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): All applicable key standards under this section were checked at the last inspection. EVIDENCE: Holmes House Care Home DS0000058967.V282550.R01.S.doc Version 5.1 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 the following standard(s): 7, 8, 9 Residents benefit from good attention to personal and health care needs. EVIDENCE: Care plans give good information about the needs of residents and how their health and welfare is monitored. Information includes detail of any concerns noted, and the involvement of GPs and other health professionals to follow-up any concerns. Staff show a good awareness of residents’ individual needs. Residents spoken with said that they felt well looked after, and that staff took good care of them. Risk assessments are in place detailing how residents are enabled to be as independent as possible, but still kept safe. A new falls prevention programme has been put in place, to attempt to minimise the number of falls residents experience. This includes individual assessment of residents, changes to the environment and equipment, such as beds, and medication reviews. The manager has noted a reduction in falls following implementation of the programme. The owners, manager and staff are commended for this development.
Holmes House Care Home DS0000058967.V282550.R01.S.doc Version 5.1 Page 11 Medication administration is good, with stocks kept safely, and records well maintained. The home has changed its supplying pharmacy, and staff have been provided with training by the pharmacist. A GP visits the home on a weekly basis to see any residents who need attention, but GP services can be called on outside these times as required. A new staff room has been established, for the safekeeping of all files and documents relevant to staff, which enables information to be passed to staff more effectively. Holmes House Care Home DS0000058967.V282550.R01.S.doc Version 5.1 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 the following standard(s): 12, 13 The provision of a range of social activities and contact with relatives promotes residents’ wellbeing. EVIDENCE: There are a range of activities offered to residents, and residents confirmed that they enjoy taking part. Residents are able to see relatives and other visitors when they choose to, and to form friendships with each other. On the day of inspection, residents and relatives were welcomed to attend a residents meeting. Relatives expressed positive views about staff and the care given to residents. Although menus and food provision were not specifically looked at, it was noted that a greater range of fruit and vegetables has been introduced into the menu, giving better nutritional value to residents. Holmes House Care Home DS0000058967.V282550.R01.S.doc Version 5.1 Page 13 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 the following standard(s): 18 Good training and staff awareness promote the protection of residents from abuse. EVIDENCE: Staff have undertaken training relating to protection of vulnerable adults from abuse. Staff showed good awareness of the need to protect vulnerable adults and action that must be taken if they were to have any concerns. Holmes House Care Home DS0000058967.V282550.R01.S.doc Version 5.1 Page 14 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 the following standard(s): All applicable key standards under this section were checked at the last inspection. EVIDENCE: A brief tour of some parts of the home was undertaken and all areas seen were found to be clean, tidy and hygienic. Some areas of the home have been recarpeted since the last inspection. . Holmes House Care Home DS0000058967.V282550.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 30 Residents’ needs are met by staffing arrangements in the home. EVIDENCE: Staffing levels were sufficient at the time of inspection to meet the needs of residents. Staff undertake ongoing training in a range of areas, to help them to do their work well, for example first aid, food hygiene, moving and handling. A number of staff have undertaken National Vocational Qualifications in care. The manager and staff are commended for their commitment to ongoing training. Holmes House Care Home DS0000058967.V282550.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): All applicable key standards under this section were checked at the last inspection. EVIDENCE: Although the key standards were not checked in detail, the following aspects were noted at inspection: The registered manager continues her professional development, and has almost completed the Registered Managers Award. Residents are enabled to give their views about the running of the home at residents’ meetings. Relatives are also invited to attend Holmes House Care Home DS0000058967.V282550.R01.S.doc Version 5.1 Page 17 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 X X X X X X X X STAFFING Standard No Score 27 3 28 X 29 X 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x X X X X X X X Holmes House Care Home DS0000058967.V282550.R01.S.doc Version 5.1 Page 18 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. Refer to Standard Good Practice Recommendations Holmes House Care Home DS0000058967.V282550.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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