Inspection on 03/08/05 for Holmesdale House

This inspection was carried out on 3rd August 2005.

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 14/02/07

Holmesdale House 30/12/05

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 Susex TN39 3QE Lead Inspector James Houston Unannounced 3 August 2005 10:00 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 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 H59-H10 S21362 Holmesdale House V230752 030805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Holmesdale House Address 3 Holmesdale Road Bexhill-on-Sea East Sussex TN39 3QE 01424 217953 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 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 (OP), 6 of places Holmesdale House H59-H10 S21362 Holmesdale House V230752 030805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum number of service users to be accommodated is six (6) 2. That the care home can provide residential care to older people aged sixtyfive (65) years or over on admission Date of last inspection 11 January 2005 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 is decorated to a high standard. There is a large attractive back garden with a sun terrace and several seating areas. Each resident has their own bedroom: five of these overlook the back garden. The bedrooms are light, well-maintained and comfortable. Residents have the use of two lounges and a conseratory/dining room. The manager with her husband, son and daughter-in -law provides the majority of care. This team is supported by a small group of carers. Holmesdale House H59-H10 S21362 Holmesdale House V230752 030805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place during the morning and early afternoon of the third of August 2005. Before the inspection papers held by the Commission for Social Care Inspection were read and those standards to be assessed prepared. The inspection in the home took 5.1 hours. A tour was made of the premises. The inspector spoke with all the residents, a visiting relative, a visiting social worker, the owner/manager and a staff member. Four care plans were read. There were six residents accommodated in the home on the day of the inspection. What the service does well: What has improved since the last inspection? 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. Holmesdale House H59-H10 S21362 Holmesdale House V230752 030805 Stage 4.doc Version 1.40 Page 6 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 Standards Statutory Requirements Identified During the Inspection Holmesdale House H59-H10 S21362 Holmesdale House V230752 030805 Stage 4.doc Version 1.40 Page 7 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 standard(s) 1,4 and 6. The home gives full information to prospective residents and their representatives to assist in the decision as to whether to seek admission. The home meets the needs of the current group of residents. EVIDENCE: The copy of the service users’ guide and statement of purpose made available for inspection were well drawn up. Minor points of detail were discussed and dealt with during the inspection. From discussion with the residents, visitors to the home, staff and the owner/ manager, observation and the reading of records the inspector reached the conclusion that staff individually and collectively have the skills and experience to deliver the care and services which the home offers to provide. The home does not offer intermediate care. Holmesdale House H59-H10 S21362 Holmesdale House V230752 030805 Stage 4.doc Version 1.40 Page 8 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 standard(s) 7,9 and 11. Care planning is to a good standard. The home has good systems for the care dying residents. EVIDENCE: Four care plans were inspected. They showed that full initial assessments are conducted, and that initial care plans are signed by residents. Residents said that they had been involved in the making of these plans. Evidence was seen that goals are set out and risk assessments undertaken, and that these are reviewed monthly. Daily updates are noted and these were found to be fully up to date. Residents whose medication is administered by the home said that this works smoothly. Four residents currently self-medicate, and a file sampled showed that a risk assessment regarding the suitability of this had been undertaken. A resident said they value this freedom, and keep their medication under lock and key in a secure facility provided in their room. The record of medicines administered was found to be fully kept. A staff member said that they had received suitable training from a local pharmacist. Holmesdale House H59-H10 S21362 Holmesdale House V230752 030805 Stage 4.doc Version 1.40 Page 9 Since the last inspection the home has written a suitable policy on the care of dying residents and the staff member was aware of this. The home has an appropriate policy on the actions to be taken in the event of the death of a resident and information to enable the wishes of residents about actions to be taken after their death is recorded on residents’ care plans. Holmesdale House H59-H10 S21362 Holmesdale House V230752 030805 Stage 4.doc Version 1.40 Page 10 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 standard(s) 12 and 13. Residents lead fulfilling lives matching their expectations and preferences. Visitors are made welcome. EVIDENCE: Residents said that they are able to lead their lives in the way that they decide, for example choosing when to get up and where they take their meals. A resident said that several of them meet in the afternoon to do crosswords. The home has a group of active residents who said that they go out of the home regularly on their own and/or with family and friends. A resident said that she continues to go to a club she belonged to before coming in to the home. Occasional meals out are arranged for residents and they said that feel free to go or not as they please. Residents and a visitor said that visitors are made most welcome in the home, being welcomed and offered hospitality by staff. Staff said that this is an important part of their role. Holmesdale House H59-H10 S21362 Holmesdale House V230752 030805 Stage 4.doc Version 1.40 Page 11 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 standard(s) 16 and 18. The home has suitable arrangements to deal with any complaints made to it. The home’s procedures, processes and training for staff are designed to protect residents in the event of any abuse or allegation of abuse. EVIDENCE: The home has a suitable complaints policy which was inspected. The owner/manager has amended the name of the registering authority since the last inspection. Residents said that there are fully aware of the policy and would be able to use it if the need arose but that they have no complaints. The owner/manager agreed to keep a specific log to hold any complaints that might arise in the future. The home has a suitable adult protection policy, a whistle-blowing policy and a copy of the East Sussex Brighton and Hove document on Protection of Vulnerable Adults. Staff confirmed that they have received training in adult protection. The owner/manager said that the procedures have not had to be invoked in respect of anyone in the home. Holmesdale House H59-H10 S21362 Holmesdale House V230752 030805 Stage 4.doc Version 1.40 Page 12 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 standard(s) 19,20,24,25, and 26. The home provides accommodation to a good standard. Communal areas and bedrooms are presented to a high standard. Residents live in safe comfortable surroundings. Laundry facilities are suitable. EVIDENCE: The home provides residents with an environment that is maintained to a very high standard. A resident gave this as one of their reasons for choosing the home. One fire door needs adjusting. The home has extensive, and well-kept gardens, with a large gazebo in the grounds. A resident said that there is a vegetable garden at the end, which provides fresh produce for the home. Some grouting of a paved area in the garden needs completing, and a garden gate needs easing. Communal areas are ample for the small resident group. There are two lounges and a conservatory and a dining area. Furnishings and lighting are domestic in character and of good quality. Holmesdale House H59-H10 S21362 Holmesdale House V230752 030805 Stage 4.doc Version 1.40 Page 13 Residents said that they like their rooms, which are maintained to a high standard. Residents said that they have been able to bring in items of their own and appreciate this facility. Records inspected showed that the home keeps an inventory of items brought into the home by residents. Residents said that they can lock their doors but do not choose to do so. They confirmed that they have a lockable facility in their rooms, which they appreciate. Since the last inspection towel rail rails have been checked so that they are not so hot as to pose a risk to residents. Those checked during the inspection were not dangerously hot. The manager now has a suitable policy for the prevention of risks from Legionella and is reviewing actions necessary to implement it. Rooms are individually and naturally ventilated. Lighting in residents’ rooms is domestic in character. The home’s laundry is suitably sited away from food preparation areas, and well equipped. Residents said that the home’s laundry service works well for them. They said that they appreciate how clean and tidy the home is. Holmesdale House H59-H10 S21362 Holmesdale House V230752 030805 Stage 4.doc Version 1.40 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 28,29, and 30. Recommended qualification levels for staff have not been attained. Recruitment processes need some attention. The home has a commitment to staff training. EVIDENCE: The manager said that one staff member has almost completed NVQ level 3, and the staff member spoken to confirmed that she expects to complete NVQ level 2 shortly. When these staff complete their qualifications the recommended levels of qualification will have been met. The staff files inspected showed that two references have now been obtained on each staff member. A staff member confirmed that she had been given a copy of the General Social Care Council Code of Conduct. Staff files showed that evidence of identity including a recent photograph was not held for one staff member and a CV was not held for either staff member. Records showed that staff have a suitable job description and terms and conditions of employment. Records inspected showed that a programme of induction and foundation training has been completed for staff in the home. Holmesdale House H59-H10 S21362 Holmesdale House V230752 030805 Stage 4.doc Version 1.40 Page 15 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,35,36,38 The manager leads the home well. It has an open and positive atmosphere. The home does not have an involvement in residents’ finances. Formal supervision must be established. The health and safety of residents are protected. EVIDENCE: The registered manager has many years relevant experience and is a trained nurse. She has completed NVQ level three in care and is doing the registered managers award. She is aware of the recommendation that this be completed by 2005. She undertakes periodic training to update her skills. Residents said that the owners of the home are very easy to get along with and make a point of meeting with residents on a very regular basis. They said that they like the small family –type feel of the home, and consider that this works well. A staff member said that the home is a lovely place to work. Holmesdale House H59-H10 S21362 Holmesdale House V230752 030805 Stage 4.doc Version 1.40 Page 16 Residents said that they and their families handle their own finances, and that the home does not get involved. The owner/manager confirmed that this is the case. She has the facility to hold small items securely, but at present this is not required. The owner/manager and a staff member confirmed that regular recorded supervision has not yet started. The owner /manager has obtained a supervision and appraisal format from a commercial provider and there was evidence of preparation, and that implementation will commence shortly. This is outstanding from the last inspection. Some fire doors were found to be wedged open during the inspection, and the manager removed the wedges. Fire alarm points are checked weekly and fire fighting equipment is serviced regularly. There was evidence that two new staff members had received recent fire training. A record of fire training given to all staff should be kept. There was evidence that gas and electricity systems and portable electrical appliances have been tested recently. The home has three qualified first aiders, and the manager will review the qualifications of all staff left in charge of the home. Staff confirmed that they have had training in food handling, food hygiene and infection control. The home’s accident record was inspected and was found to be well kept. Holmesdale House H59-H10 S21362 Holmesdale House V230752 030805 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x x 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x COMPLAINTS AND PROTECTION 3 3 x x x 3 3 3 STAFFING Standard No Score 27 x 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 x x 3 2 x 3 Holmesdale House H59-H10 S21362 Holmesdale House V230752 030805 Stage 4.doc Version 1.40 Page 18 YES Are there any outstanding requirements from the last inspection? 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. 2. Standard 29 36 Regulation 19(1) 18(2) Requirement That all the required records are kept on staff employed. That a formal process of documented supervision is implemented.(Previous timescale of 1/3/05 not met). Timescale for action 31 August 2005 31August 2005 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. 2. 3. Refer to Standard 19 28 31 Good Practice Recommendations Attend to minor maintenance items identified at the inspection. 50 of care staff obtain NVQ 2 in care by 2005. The manager obtain NVQ level 4 in care and management by 2005. Holmesdale House H59-H10 S21362 Holmesdale House V230752 030805 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Ivy House 3 Ivy Terrace Eastbourne East Susssex BN21 4QT National Enquiry Line: 0845 015 0120 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 H59-H10 S21362 Holmesdale House V230752 030805 Stage 4.doc Version 1.40 Page 20 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!