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Inspection on 17/12/08 for Holmesdale House

Also see our care home review for Holmesdale House for more information

This inspection was carried out on 17th December 2008.

It is an annual review prepared by CSCI after examining previous reports and information from the provider. At the time of this report, CSCI judged the service to be Good.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Annual service review Name of Service: Holmesdale House The quality rating for this care home is: The rating was made on: two star good service 1 2 0 1 2 0 0 9 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 review of the service. We call this review a ‘key’ inspection We do an annual service review when there has been no key inspection of the service in the last 12 months. It does not involve a visit to the service but is a summary of new information given to us, or collected by us, since the last key inspection or annual service review.   Has this annual service review changed our opinion of the service?   No You should read the last key inspection report for this service to get a full picture of how well outcomes for the people using the service are being met. The date by which we will do a key inspection: Name of inspector: June Davies Date of this annual service review: 2 0 1 1 2 0 0 9 Annual Service Review Page 1 of 8 Information about the service Address of service: 3 Holmesdale Road Bexhill-on-sea East Sussex TN39 3QE 01424217953 01424224889 holmesdale.house@virgin.net Telephone number: Fax number: Email address: Provider web address:   Name of registered provider(s): Conditions of registration: Category(ies) : old age, not falling within any other category Conditions of registration: Mrs Pamela Vidal,Mr Elias Vidal Number of places (if applicable): Under 65 Over 65 0 6 The maximum number of service users to be accommodated is 6 The registered person may provide the following category of service only; Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (OP) Have there been any changes in the ownership, management or the Yes service’s registration details in the last 12 months? If yes, what have they been: There have been no changes in registration in the last 12 months 1 2 0 1 2 0 0 9 Date of last key inspection: Date of last annual service review (if applicable): 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 Annual Service Review Page 2 of 8 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. Weekly fee charges can be made by application to the Registered Provider/Manager Annual Service Review Page 3 of 8 Service update since the last key inspection or annual service review: What did we do for this annual service review? We looked at all the information that we have received, or asked for, since the last key inspection. This included: The annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. Information we have about how the service has managed complaints. What the service has told us about things that have happened in the service, these are called notifications and are a legal requirement. The previous key inspection and the results of any other visits that we have made to the service in the last 12 months. Relevant information from other organisations. What other people have told us about the service. What has this told us about the service? The home returned the annual quality assurance assessment (AQAA) when we asked for it. The AQAA provided us with clear and comprehensive information. It provided us with details of what the home does well, what they could do better and plans for improvement within the next twelve months. The home keeps its Statement of Purpose and Service User Guide under review. The home has also produced a new brochure, that contains colourful photographs and a written description of the home. Prospective residents are always given the introductory documents and invited to visit the home and can also spend a respite period in the home if they wish to, so they are able to meet other residents and the staff. Prior to admission the registered provider/manager carries out a comprehensive pre-admission assessment, which is used to ensure the home can meet the residents needs and to form the basis for a care plan. Residents are involved with their own care planning so that their choices, preferences and wishes are included in how they wish their assessed care needs to be delivered. There was a requirement made at the last key inspection in January 2009, that while care plans contained risk assessments these tended to be generic and not related to risks that are relevant to individuals. This requirement has now been met and each resident has their own individual risk assessment pertaining to risks they may encounter in their everyday living routines. Care plans and risk assessments are reviewed on a regular basis and any changes in care are recorded. Good evidence is contained in each residents care plan in relation to contact with external health care professionals. At the last key inspection a requirement was made in regard to Annual Service Review Page 4 of 8 medication and how the home manages over the counter remedies and PRN (as required) medication. Since this inspection the home has obtained a homely remedies policy which has been signed by each residents General Practitioner. The registered provider/manager has also put in place individual information on the administration of PRN (as required) medication. The receipt, storage, recording, administration and return of medication is now well managed within the home. Residents in the home are treated with respect by the staff who also ensure that residents rights to privacy and dignity are upheld. Residents are able to make their own choices in regard to their daily living routines. The home has introduced a more structured activities rota as many of the residents are not able to get out into the community and socialise as they used to. Residents have been instrumental in choosing activities they would like to participate in. Regular resident meetings are held where residents are able to make decisions in regard to inhouse activities, access to the community and choice of food. The registered provider/manager is also looking at external entertainers coming to the home to provide entertainment from time to time for the residents. Residents families and friends have unrestricted visiting to the home. Most residents enjoy the gardens at the home and some residents are able to access local amenities as and when they wish to. All activities are carefully planned and recorded into each residents daily diary sheet. All residents in the home are able to have their own private telephone in their bedroom this also gives them links to their families and friends. Menus in the home are varied, wholesome and appetising. Residents are able to make choices in what they would like to eat at each mealtime. Fresh fruit is always available to the residents and they are able to help themselves from the fruit bowl. The home can cater for specialised diets as and when required. At the last key inspection residents told the inspector that all food in the home was really good. The home has an up to date complaints policy and procedure. Residents know how to make a complaint if they need to. There have been no formal complaints made to the home since the last inspection. The registered provider/manager is in the home on a daily basis and any issues that may be concerning residents are discussed and usually resolved before they become an official complaint. Residents are encouraged to express their views, likes and dislikes. The home has recently reviewed its Safeguarding Vulnerable Adults policy and procedure in October 2009. There have been no Safeguarding Vulnerable Adults referrals to Social Services since the last key inspection. All staff are aware of the Safeguarding Vulnerable Adults policy and procedure, and have also received training in the Safeguarding of Vulnerable Adults. Recruitment practises have improved since the last key inspection and the registered manager/provider ensures that all prospective staff are appropriately vetted prior to taking up employment in the home. The environment of the home is maintained to a high standard, offering it residents a warm, comfortable and homely place to live. The garden is very accessible to frail elderly residents and they are free to use the garden as and when they wish. Each bedroom is furnished to the residents preference, and residents are encouraged to bring small items of furniture and treasured possessions into the home with them. All bedrooms in the home have en suite facilities. The home is free from offensive odours, and infection control procedures are strictly adhered to, so that residents are not placed at risk from cross infection. The home has an ongoing maintenance programme, to ensure the environment is always presented to a high standard. Annual Service Review Page 5 of 8 There is a small team of staff at Holmesdale House. The staff turnover in the home is minimal, with the majority of care staff having worked at the home for a number of years. Many of the residents in the home are independent and only require assistance from time to time. The registered provider/manager is usually rostered on duty with one member of care staff. At the last key inspection residents said that there are always enough staff on duty to meet their needs. The home also employs casual and temporary staff who are well known to the registered providers and residents, this ensures that the home does not have to use agency staff to cover for annual leave or staff sickness. Domestic staff are also employed in the home on a daily basis. Two members of care staff have obtained their NVQ qualification in Social Care. All staff have now attended mandatory training sessions and this ensures that a requirement made at the last key inspection has been met. The AQAA also provides evidence that staff have participated in work related training, such as - Good Nutrition, Record Keeping and Report Writing and Falls Prevention. Following a requirement made at the last key inspection regarding the appropriate vetting of staff prior to them being employed in the home, the registered provider/manager has recently employed a housekeeping member of staff and has ensured that all appropriate checks have been carried out, prior to her starting work. The registered provider/manager has owned Holmesdale House for over thirty years and has gained her Registered Manager Award. At the last key inspection the inspector observed that the registered provider/manager has a good working relationship with her staff and is very approachable. Residents spoke highly of the registered/provider saying that she is always available to them. The quality assurance system in the home has been developed further with the views of residents, families, friends and staff being sought and acted upon to make improvements to the home and daily routines and care for the residents. The registered provider/manager works in the home daily and therefore ensure that all systems in the home are kept up to date. Fire, health and safety are regularly checked and risk assessed to ensure that residents live in a safe environment. The home does not manager any of the resident personal allowances. Residents themselves have made their own arrangements for receiving and the safekeeping of their personal allowances. At the last key inspection the inspector evidenced that all staff receive regular formal supervision, and it is from this that training needs are identified. All appliances used in the home have an up to date maintenance certificate. Regular inhouse recorded checks are carried out on the fire call points, door guards, emergency lighting, call bell system and hot water delivery temperatures. If any resident falls or there is an incident in the home this is recorded directly into the accident book. What are we going to do as a result of this annual service review? There will be no change to the Inspection plan and we will do a Key Inspection by the 11th January 2011 However, we can inspect the service at any time if we have concerns about the quality of the service or the safety of the people using the service. Annual Service Review Page 6 of 8 Annual Service Review Page 7 of 8 Reader Information Document Purpose: Author: Audience: Further copies from: Annual service review CQC General Public 0870 240 7535 (national contact centre) Our duty to regulate social care services is set out in the Care Standards Act 2000. The content of which can be found on our website. 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