Inspection on 14/02/07 for Holmesdale House

This inspection was carried out on 14th February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Holmesdale House 17/12/08

Holmesdale House 30/12/05

Holmesdale House 03/08/05

Holmesdale House 11/01/05

Holmesdale House 28/06/04

Similar services:

Old Hastings House

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

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

CARE HOMES FOR OLDER PEOPLE Holmesdale House 3 Holmesdale Road Bexhill-on-sea East Sussex TN39 3QE Lead Inspector Jeanette Denereaz Key Unannounced Inspection 14th February 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 Holmesdale House DS0000021362.V326264.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. Holmesdale House DS0000021362.V326264.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Holmesdale House Address 3 Holmesdale Road Bexhill-on-sea East Sussex TN39 3QE 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) 01424 217953 01424 224889 holmesdalehouse@v21_mc_uk Mr Elias Vidal Mrs Pamela Vidal Mrs Pamela Vidal Care Home 6 Category(ies) of Old age, not falling within any other category registration, with number (6) of places Holmesdale House DS0000021362.V326264.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users to be accommodated is six (6) That the care home can provide residential care to older people aged sixty-five (65) years or over on admission. 30th December 2005 Date of last inspection Brief Description of the Service: Holmesdale House is a detached family house situated in a residential road in the centre of Bexhill-on-Sea. The home is family run with resident owners and can cater for up to six older people. Holmesdale House is decorated to a high standard. There is a large attractive back garden with a sun terrace and several seating areas. Residents have their own bedroom with en suite lavatory and wash hand basin. Five of the bedrooms over look the back garden and there is level access to the garden. The bedrooms are light and well maintained and comfortable. Residents have the use of two lounges and a conservatory that is used for dining. The Registered Manager and her husband, provide the majority of care with the support of a small group of carers. The current scales of fees range from £371.00 to £420.00 per week. Holmesdale House DS0000021362.V326264.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulations 2001, uses the term ‘service user’ to describe those living in care home settings. For the purpose of this report, those living at Holmesdale House are referred to as ‘residents’. This report reflects a key inspection based on the collation of information received since the last inspection and an unannounced site visit conducted by an Inspector on the 14th February 2007. The site visit included a tour of the premises and an examination of various records including medication, care and staffing records. The Inspector met with the registered manager, staff member on duty and the registered manager’s husband, who is also joint proprietor. The residents were sent a ‘Have your say’ about Holmesdale House survey, and all six were returned, and from information gathered residents were very happy with the care they received. The surveys invite service users to speak to the inspector, and one resident request to speak, and during the visit all the residents chatted to the inspector. The newest resident has only lived in the home for seven months, but she was told about the home from a mobile librarian, who knew she was not coping well at home. She informed the inspector that: “I’m very lucky to be living here.” Another resident become very emotional because she also felt very fortunate to be living at Holmedales House, when there are other older people not so lucky. Also during this inspection process relatives of the three new residents were contacted and they gave praise to the home and made statements: “It is an excellent home.” “The manager is wonderful and she and xxxx(staff) are very good cooks”. “I have a very good relationship with the home”. They also talked about the homely atmosphere, and gave examples, including how the proprietors spend time with the residents and how nothing was too much trouble. They all felt their relatives were very lucky to living at Holmesdale House. What the service does well: Holmesdale House DS0000021362.V326264.R01.S.doc Version 5.2 Page 6 Holmesdale House offers a high quality standard of accommodation, with all bedrooms offering light and space with en-suite facilities and the communal areas are also decorated and furnished to the same high and tasteful standard. The quality and quantity of the food is very good and the dining room which is a conservatory, looking out onto the garden, which is very attractive. The Décor and furnishings are maintained to a good standard with an ongoing decorating plan to further enhance and update the home. The home was found to do everything well, excelling in some areas. The home continues to make improvements between inspections. The home was found to provide good support and the management team and staff are good at ensuring residents have a good and comfortable life. It was evident that friends and family members are welcome, and this was confirmed by the entries of the visitors’ book and from conversations with relatives to the inspector. Staff member on duty spoke positively about the home, and commented that she really enjoyed her work. The manager and her husband are committed to providing a good quality of care for residents but also ensuring that staff are well supported. The home has a good atmosphere it is friendly, unhurried and gentile with all residents receiving attention. The residents have a zest for life and are encouraged to be independent; this was evident from the daily records and with chatting to the residents. They enjoy going out and some still go out independently. The newest resident lived nearby and continues to see her friends regularly. What has improved since the last inspection? All care staff have National Vocational Qualifications (NVQ) in care levels 2 and 3, with one staff member working toward NVQ4. The manager has successfully completed her Registered Manager’s Award (RMA). Record keeping is continually being reviews and updated and the care plans seen by the inspector were clear and concise, but there is a need for more detailed information to be recorded following medical appointments and procedures Staff supervision is now undertaken and the staff and residents’ meetings are taking place regularly, and are recorded. The manager is in the process of devising a quality assurance programme to gather views from residents and other interested people to ensure the quality of the service is of a high standard and meeting residents’ changing needs. The manager has risk assessed the storage of the medication for the selfmedicating resident and at this present time there is a very low risk of other residents taking this medication, but the manager is aware this situation will be under constant review. Holmesdale House DS0000021362.V326264.R01.S.doc Version 5.2 Page 7 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Holmesdale House DS0000021362.V326264.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 Holmesdale House DS0000021362.V326264.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): 1,3,4 & 5 (Standard 6 is not applicable; the home does not offer intermediate care) Quality in this outcome area is Excellent. This judgement has been made using available evidence including a visit to this service. Significant time and effort is spent making admissions to the home personal and well managed. Prospective residents and their families are treated with dignity, respect and understanding for the life changing decisions they need to make EVIDENCE: The inspector looked at the care plans and information for the newest resident to the home since the last inspection, and she agreed to speak to the inspector. The resident told the inspector that the mobile librarian had told her that Holmesdale House was a good home. Holmesdale House DS0000021362.V326264.R01.S.doc Version 5.2 Page 10 The documentation confirmed the resident made contact with the home independently because it had been recommended. The information held within the care plan detailed the admission process with the manager visited the resident in her own home and a detailed pre-admission assessment was undertaken The resident visited the home, and finally moved in July 2006. The resident lived nearby and she still has frequent contact with family and friends. The inspector contacted her next of kin and it was evident that all the family are very happy with the home. The next of kin visits her relative often. Holmesdale House DS0000021362.V326264.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 & 10 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Resident’s can be assured their health needs are fully met. They are treated with the highest levels of respect with all steps taken to meet their needs and preferences. EVIDENCE: Since the last inspection all care plans have now been reviewed and they are used as a working tool and the staff understands the information and they are encourage to write up the daily entries. However, the inspector discussed with the manager the need for more information regarding medical visits and procedures to ensure the staff are aware and give the correct care and Holmesdale House DS0000021362.V326264.R01.S.doc Version 5.2 Page 12 support. The manager agreed to review this situation, but still wanted staff to have the responsibility for writing the care plans. All resident are registered with local GPs. The home has input from other health professionals and staff and certain family members support residents to attend hospital and other medical appointments Comments in the survey stated that one resident’s health is deteriorating and her needs are changing. The inspector contacted the family and they said they were very impressed with the way the manager and staff are supporting their mother, and if she has to be moved they fully expect this to be done in a dignified manner. The manager has risk assessed the storage of the medication for the selfmedicating resident, which gave concern at the last inspection. Following the risk assessment the manger has concluded that at this present time there is a very low risk of other residents taking this medication, but the manager is aware this situation will be under constant review. . Throughout this inspection visit and on other visit to the home, it is evident that the residents are treated with dignity and respect. The residents spoke freely about the manager and staff with affection and all were very relaxed within the home. Also during this inspection visit the hairdresser was at the home, and it was observed by the inspector that she to was very respectful and spends time chatting to each individual resident booked to have their hair washed and set. The manager said she was very pleased with the service from the hairdresser and that she was very patience and did not rush the residents and spend time with each resident. Holmesdale House DS0000021362.V326264.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 &15 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The home provides good range of activities based on resident preferences. Residents are supported to have a full community profile and access facilities as well as maintain relationships. EVIDENCE: The residents commented in the survey and told the inspector during this inspection visit that they enjoyed their lives at Holmesdale House, and one resident become very emotional and said she was so lucky to be living here. The inspector was invited to the lunch, and the meal was casserole of beef with dumplings, followed by a choice of desserts with coffee or tea to follow. At the lunch time the inspector took the opportunity to spend time with the staff, and after the residents had eaten she spend time with them chatting about the Holmesdale House DS0000021362.V326264.R01.S.doc Version 5.2 Page 14 food and they all said they really enjoyed the food and there was always plenty of choice and always good portions. The inspector observed the staff member serving the meal with respect for the residents, and when they had finished the meal she returned to get their request for the evening meal, and they all ordered different things. . There is a tradition within the home for the residents to do the crossword in the afternoons, and all take part. The relatives also mentioned the afternoon crossword session, and how competitive and stimulating this activity is for the residents. Most residents are still active within the community, and in the summer months they go out independently, the manager is aware that this is not an option for others now and there are planned outings with staff support. The newest resident was living very near the home, and she still has many friends in the local area and attends church regularly. Most the residents have frequent visits from family and friends and family members contacted by the inspector said they are always made to feel welcome at the home. Holmesdale House DS0000021362.V326264.R01.S.doc Version 5.2 Page 15 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): 16,17 & 18 Quality in this outcome area is Good this judgement has been made using available evidence including a visit to this service. The home operates in an open and pro-active manner. Residents continue to have all their rights upheld. All residents and visitors are made fully aware of how to complain or raise concerns. Residents confirmed they understood the procedure and would always feel comfortable talking to the manager and staff. EVIDENCE: There are no recorded complaints or concerns since the last inspection. The home operates in an open and pro-active manner. The manager and staff demonstrated a sound understanding on how to prevent abuse, with all staff receive relevant training through NVQ, and the manager is looking into offering staff further training in the protection from adult abuse. Residents informed the inspector that they are very happy living at Holmesdale House, and if they were unhappy they would always speak to the manager. Holmesdale House DS0000021362.V326264.R01.S.doc Version 5.2 Page 16 It was observed that the staff acted very respectfully toward the residents. The politeness and respectfulness of the staff was observed by the inspector and by the relative interviewed during this inspector process. Holmesdale House DS0000021362.V326264.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): 19,20,21,23,24,25 & 26 Quality in this outcome area is Excellent. This judgement has been made using available evidence including a visit to this service. The residents live in a well maintained, furnished and clean home. The home’s location and layout is very impressive and very homely. It is well maintained to a very high standard with good furnishing and décor. All the residents’ benefit from excellent rooms with en-suite facilities and most having views across onto the courtyard and garden. EVIDENCE: The Inspector toured communal parts of the home such as lounges, bathrooms and dining area along with hallways finding them all to be clean. There is a range of comfortable communal areas, including lounge and dining room. The inspector spent time with all the residents and visited them in their Holmesdale House DS0000021362.V326264.R01.S.doc Version 5.2 Page 18 bedrooms. The rooms were all very nicely decorated and furnished, the newest resident was also impressed with her room, she said, she was very comfortable and felt very lucky to be living at Holmesdale House. The relatives the inspector contacted as part of this inspection process also remarked upon the excellent standard of the home. The manger informed the inspector that her husband was responsible for the general maintance of the home and there was always ongoing maintenance to ensure the home is always in good decorative order. As the manager and her husband, who are also the proprietors, also live at Holmesdale House, thus giving the premises a homely feel. The manager’s son and daughter –in-law until recently also worked within the home, and there is a family atmosphere, which included the family dog. The manager informed the inspector that at Christmas all the family and residents that are at home for Christmas day celebration Christmas dinner together. Relative contacted by the inspector commented on the homely atmosphere and how there relation enjoyed be part of the home, Holmesdale House DS0000021362.V326264.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 & 30 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. There are sufficient staff on duty to meet the needs of the residents and a cleaner is also employed to keep the home clean. It is a small but qualified staff team and residents are protected by the home’s recruitment procedure. EVIDENCE: The inspector observed the staff member working with the residents and was impressed with the respect and empathy shown by all her and the manager. When questioned the staff member had a good knowledge of the residents, and gave the residents a personal touch to their care, this is achieved by the established staff team working well together. Training is very important to the manager and the staff and are encourage to undertake training, and both staff members have gained their NVQ level 2 and 3, with one staff member working towards obtaining her NVQ4 The inspector during this inspection visit reviewed the staffing records of the newest staff member, who is the cleaner and the records and procedures were in order including references, Pova and a CRB certificate on file. Holmesdale House DS0000021362.V326264.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36, 37 & 38 Overall quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Holmesdale House is openly and well managed in the best interests of residents who are fully involved in the running of the home. The home benefits from a well-motivated manager, who is supported by a small but enthusiastic staff team. A safe environment is maintained for residents, and they are protected from harm by well-trained staff. EVIDENCE: Holmesdale House DS0000021362.V326264.R01.S.doc Version 5.2 Page 21 Since the last inspection the manager has gained the Registered Manager’s Award (RMA). and both staff have NVQ in care, with one studying further for her NVQ4 The manager has started regular supervision and the inspector saw an example of a supervision record and dates had been arranged for further supervisions for the staff. Records showed that all aspects of health and safety were being met this included looking at appliance safety certificates, staff training, and accident records. All accidents and significant incidents are promptly reported to the CSCI. The manager does endeavor to maintance all records, but she is part of the care team and the record keeping and office base activies can become disorganized. It is required the manager reviews the office management and has a system that is accessible, and confidential files are always locked away. However, the financial records for the residents in connection with the paying of the fees were in good order, with most other finaical matters being dealt with by the individuals resident and their families Holmesdale House DS0000021362.V326264.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 4 4 4 4 4 X HEALTH AND PERSONAL CARE Standard No Score 7 4 8 2 9 3 10 4 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 3 18 3 4 4 4 4 4 4 4 4 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 4 X 3 3 2 3 Holmesdale House DS0000021362.V326264.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 OP8 Regulation 12(1)(a) 13(1)(a)( b) Requirement Timescale for action 30/06/07 3. OP37 17(1)-(3) The Registered manager must ensure that holistic health care plan are completed for all residents, and that all relevant information is recorded to ensure all staff have the knowledge to observe and give correct care and support. The Registered manager must 30/06/07 ensure that all records and files held in the home’s office are secure, up to date and in good order. 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 Holmesdale House DS0000021362.V326264.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Holmesdale House DS0000021362.V326264.R01.S.doc Version 5.2 Page 25 - 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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