CARE HOMES FOR OLDER PEOPLE
Holmfield Court 58 Devonshire Avenue Leeds West Yorkshire LS8 1AY Lead Inspector
Sue Dunn Key Unannounced Inspection 30th August 2006 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 Holmfield Court DS0000001466.V306226.R02.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. Holmfield Court DS0000001466.V306226.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Holmfield Court Address 58 Devonshire Avenue Leeds West Yorkshire LS8 1AY 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) 0113 2664610 0113 2665118 Wharfedale Care Limited Mrs Catherine Mary Peel Care Home 25 Category(ies) of Dementia - over 65 years of age (8), Old age, registration, with number not falling within any other category (25) of places Holmfield Court DS0000001466.V306226.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 28th October 2005 Brief Description of the Service: Holmfield Court is a detached property located in Roundhay on the outskirts of Leeds. Car parking facilities are available at the front of the property. It is in easy access to local shops and recreational facilities, which some service users use independently. The nearby park and garden are used for trips out. Wharfedale Care Limited is the registered provider; Mrs Peel is the registered manager for the home. The home is registered as a care home for up to 25 older people. The accommodation consists of 21 single rooms 19 of which have en suite facilities, and two double rooms with en suite. There is a large communal lounge, a large dining room, and a central kitchen. There are communal bathrooms, showers and eight communal toilets. The building has had several adaptations; service users accommodation is mainly on two floors with one bedroom on the ground floor with the lounge and dining room, laundry and kitchen. Holmfield Court DS0000001466.V306226.R02.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The purpose of the inspection was to ensure the home was operating and being managed for the benefit and well being of the residents. One inspector undertook the inspection, which was unannounced. The inspection started at 10:15 am and finished at 5.30pm A pre inspection questionnaire sent to the manager had been completed at the time of the inspection and was used to support judgements made during the inspection visit. Comment cards with pre paid envelopes were sent to the home inviting people to express their views about the service. None had been returned at the time of writing. The report is based on information received from the home since the last inspection in January, observation and conversation with residents and staff, discussion with the manager, examination of 3 care files (which included case tracking two) and an inspection of the premises. This included an inspection of some bedrooms and all communal areas. The fees for the home range from £385- £480 per week. Services not included in the fees are itemised in the Statement of Purpose. What the service does well:
The home has a good format for pre admission assessments, which has compensated for the poor quality of information received from referring agencies. The format for care plans is good. It lays out needs, aims, objectives and an action plan. This has the potential to be very good if completed in a ‘person centred’ way which reflects the diversity of the people who live in the home. A particularly good example of a risk management plan minimised restrictions whilst keeping the person safe. Medication systems were sound and staff were trained and able to demonstrate that they understand the implications of the medication being given. Some people were seen to enjoy a glass of sherry or wine with their lunch. The home organises entertainers (a singer was visiting on the day of the inspection) and there was evidence that people could retain their skills and feeling of usefulness by assisting with simple domestic tasks. Senior staff took an interest in the people they were caring for and were knowledgeable, competent and prepared to accept suggestions for improvement. Holmfield Court DS0000001466.V306226.R02.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better:
The Statement of purpose could be improved with the addition of colour and visual prompts to make for easier reading. The manager is advised to request better quality information from social workers/hospital staff seeking to place people in the home. The use of pre printed text in care plans does not give a clear picture of the individual. The care plans need to be more specific and ‘person centred’ if they are to be effective and should draw on information gathered from service users and their relatives. This is outstanding from previous inspections. The information recorded in care plans could be more consistent if the better care plans were used as an example for staff to follow. More could be done to focus the social and recreational aspects of care planning to ensure diverse needs are met. More thought could be given to improving mealtimes and increasing choice and independence and to encourage conversation at mealtimes. Food was plated in the kitchen, reducing the opportunity for those who were able to serve themselves or choose their portion sizes. A soft diets should be served in separate components to allow people to experience differences in flavour. The activities programme could be more ‘person centred’ by placing more emphasis on past life experiences and skills. This is particularly important for people with dementia if they are to retain existing abilities. All service users should be made aware of their rights, as some may have preconceived ideas about their right to make choices, feeling this may not be in accordance with the views of staff. Staff training should include ‘person centred’ dementia care training, which involves looking at how systems can be tailored to the needs and diversity of each individual, rather than the individual fitting into the systems. This would have a knock on effect on the development of care plans and benefit all service users. Service users who move into shared rooms should be given the choice to move to a single room when the opportunity arises. The lock on the door of the w/c on the top floor needed repairing; the ceiling panel in the room adjoining the laundry must be replaced. It is acknowledged that there are plans to deal with the unpleasant odour in one of the bedrooms but this had not yet been resolved.
Holmfield Court DS0000001466.V306226.R02.S.doc Version 5.2 Page 7 The outdoor space should be made secure to allow people with dementia to walk about freely outdoors. It was disappointing to note that some service users personal allowances were in arrears as the people handling their finances were not providing sufficient weekly personal allowance for their needs. The home was having to subsidise several people to ensure they had sufficient money for their needs. The manager is advised to put information about personal allowances in the Statement of Purpose. 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. Holmfield Court DS0000001466.V306226.R02.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 Holmfield Court DS0000001466.V306226.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4 and 5 (6 N/A) Quality in this outcome area is good. The judgement is based on all the available evidence including information from the pre inspection questionnaire, Discussion with the manager, staff and residents and examination of documentation. The Statement of Purpose was up to date and provided basic information in a standard format. This could be improved by making the document more visually interesting and easier to read. The assessment information from other care management teams could be improved upon if the home were to take a firm line about what is acceptable. EVIDENCE: The Statement of Purpose was updated April 06, though not in a format to make easy reading for people with sight problems. The manager said that it could be produced in larger print on request. The document could be improved further with the addition of colour and visual prompts. The document itemises the services, which are not included in the fees, and informs people they can stay for lunch and trial visits as part of their introduction to the home.
Holmfield Court DS0000001466.V306226.R02.S.doc Version 5.2 Page 10 Three pre admission assessments were inspected and showed that assessments had been carried out before admission. One had a good background history to give staff some insight into the needs of the person they were caring for. This should be aimed for in all assessments to ensure the home is equipped to meet overall needs. A joint care assessment referral was very basic and hospital discharge note so badly photocopied as to be almost unreadable. Neither identified the person’s care needs. The manager is advised to request better quality information from other referral agencies before carrying out her own assessment. Holmfield Court DS0000001466.V306226.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality outcomes in this area are adequate. This judgement is based on all the available evidence, which included, examination of care plans, discussion with the manager, staff and service users and observation. The care plans were not detailed enough to give a picture of what the home was doing to meet peoples’ needs though staff and service users were able to describe the care. Some service users were very satisfied, others appeared to have unmet social and emotional needs. It was clear during conversation that the manager takes an interest in the well being of service users and tries to provide people with a good quality of life. Areas of good practice were seen and spoken of but this was not reflected in the documentation. Medication systems were sound and staff familiar with the medication in use. More could be done to improve the opportunity for conversation, choice and independence at mealtimes. EVIDENCE: A selection of care files was examined before meeting the service users. The GP arrived during the visit to meet and register a person recently admitted to the home.
Holmfield Court DS0000001466.V306226.R02.S.doc Version 5.2 Page 12 Valuables were listed in the care files seen but the list did not include personal belongings and clothing for purposes of identification. It is recommended that any more expensive items of clothing be listed as disputes about clothing has been known to cause problems in other care homes. The format of the care plans provided a good basis for guidance as it included identified needs, aims, objectives and an action plan. The content however was transferred from a pre printed script with each service users name inserted as required. The information was wordy, difficult to read and unrelated to the individual. Those care plans which had additional hand written information were much stronger as they showed a ‘person centred’ approach. This is particularly important when caring for people with dementia. Some general terms were used such as ‘No insight into personal safety’. This should have been more specific and included guidance on how any risks might be reduced. The daily records written by staff could be cross- referenced to the care plans. However, staff should guard against making hasty judgements. One entry suggesting an assessment by the continence adviser was rather premature as there was no evidence to show that other causes, such as anxiety and being in a strange environment had been investigated. Another entry was judgemental indicating a lack of empathy with the service user. Some files were better than others regarding the content of background information that could be used to inform care. Risk assessments had been done. A particularly good management plan was in place for a person who was at risk of leaving the home and getting lost. Some inconsistencies were seen indicating staff were not entirely confident about the care plans. There was a good action plan for a person who had difficulty sleeping though this had not been identified as a ‘need’. The admission record for one person simply repeated what was recorded in the assessment, which seemed unnecessary and time consuming. It raised the question of whether the staff were reading the assessment and care plan information. The social care plans were very general and did not draw on the information seen in some files about past interests. It was recorded that one person did not like sharing a room. Poor sleep patterns had not been associated with this and followed through. The manager agreed to look at the possibility of a single room when one became vacant. There was evidence of contact with district nurses, dentists and other health professionals. The GP voiced confidence in the manager. The care plan for treatment of a pressure ulcer needed to be more detailed as there was no associated record of nutrition or pressure relieving equipment, though this was in place. Comments from service users varied from very satisfied and contented to anxious and unsettled depending on the circumstances and perception of each individual. The lunchtime medication round was observed. The member of staff administering the medication was knowledgeable and competent. The medication systems were correctly followed. She said staff had received training from the pharmacy supplier and from a local college. One person manages her own medication.
Holmfield Court DS0000001466.V306226.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area was good. The judgement was made using all the available evidence, which included pre inspection information, examining care plans, speaking to the manager, staff and service users and observation. The staff respect the choices of people who are able to express their views but more could be done for the unmet needs of those people who are less settled. The programme of activities aims to provide interest and diversion for the whole group. This could be improved by drawing on peoples’ past life experiences and skills to adopt a more focussed approach for individuals and those people with dementia. EVIDENCE: Several service users were in their bedrooms, some using the locking device for privacy. It was clear that those people who were able to express their views could make choices and have their wishes respected. One person said she prefers to stay in her room where she can entertain visitors and described herself as ‘very contented’. She said the manager brings her ‘special treats’ Entertainer during pm Another person asked to speak to the inspector and said she had made a positive decision about the home and was very satisfied. She said she spends time in her room as she was unable to find anyone in the home with whom she could converse. She had just returned from a local store with her two visitors who commented on her very positive attitude to life.
Holmfield Court DS0000001466.V306226.R02.S.doc Version 5.2 Page 14 Another person spoke of the frustrations of no longer being able to drive a car and have control over life. This was expressed as dislike of the home and difficulties with some of the staff. Another was unsettled and unsure about why he was in the home. Staff gave some reassurances but more could have been done to help with prompts and reminders. It was good to note that one person had assisted with simple household tasks such as laying the table. A musical entertainer visited the home in the afternoon. A member of staff was cooking on the chef’s day off. Food was being plated and served from the kitchen hatch. This could make choices difficult for people with dementia who are unable to conceptualise. There was little conversation during the meal between the staff serving the meal and the service users and little encouragement for people who were sitting looking at their plates but not eating. It was good to see some people having a glass of sherry or wine with their meal. Plate guards were available to assist those with difficulty managing cutlery. The service users spoken with said the food was ‘ok’. A pureed meal had not been served in its separate components to allow the person eating the meal to distinguish between flavours. Holmfield Court DS0000001466.V306226.R02.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 and 18 Quality in this outcome area is good. The judgement is based on all the available evidence, which included discussion with the manager, the pre inspection questionnaire, discussion with service users and staff. People are aware of the complaints procedure. All staff have done adult protection training. Staff should ensure service users are clear about their rights. EVIDENCE: There had been no complaints. One person commented on an open bedroom window and had concerns that the staff would not be pleased if it were closed. The staff need to ensure that service users perceptions of their rights are understood. The information sent to the CSCI before the visit stated that one person in the home was supported by the Age Concern advocacy service. All the staff had completed Adult Protection training including a recently appointed overseas worker. Holmfield Court DS0000001466.V306226.R02.S.doc Version 5.2 Page 16 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): 19, 20, 21, 22, 23, 24, 25 and 26 Quality in this outcome area is good. The judgement is based on all the available evidence, which included discussion with service users staff and the manager, observation and a tour of the building. Most of the bedrooms were of a good size with full en-suite facilities. The manager was aware of the communal space limitations and was taking action to improve the facilities. Systems were in place for the upkeep and maintenance of the building. Odour control in the home was good and systems were in place to control risks of cross infection. Laundry facilities were small but clothing was laundered to a good standard. EVIDENCE: A general handyman is responsible for routine maintenance and repairs. And overall the home looked clean and well cared for with no unpleasant odours. One bedroom where odour control is a problem is to have the floor covering replaced. The manager/proprietor is aware of the limitations of the communal space and is planning to extend the building. The outdoor area is not secure at the
Holmfield Court DS0000001466.V306226.R02.S.doc Version 5.2 Page 17 present time but all exit doors are alarmed. If the home is to continue to care for people with dementia there should be free access from the building into a secure area of the garden to avoid undue restriction of movement. Most of the bedrooms were of a good size and in some cases had been well personalised. Most had full en suite bathrooms. Some bedroom doors creaked loudly when opened which could disturb the occupants as hourly night checks are done. The bathing facilities are to be improved by making an upstairs bathroom into a walk in shower room for those people who prefer a shower. The door to a communal lavatory on the top floor could not be locked. This could compromise privacy. The laundry was small but clean and tidy. The adjoining boiler room was rather cluttered and one of the ceiling panels was missing allowing which could breach fire safety. Personal clothing appeared well cared for and staff were making the most of the fine weather by hanging washing outside to dry. Holmfield Court DS0000001466.V306226.R02.S.doc Version 5.2 Page 18 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, 28 and 30 Quality outcomes in this area were good. The judgement is based on all the available evidence, which included, pre inspection information, discussion with the manager, staff and service users and observation of care practice. The home had a satisfactory rolling programme for training and had met the minimum requirements for staff with the NVQ award. All residents and staff would benefit from ‘person centred’ dementia care training. The attendance at staff meetings was disappointing as this is an opportunity for staff to contribute to developing the home further. EVIDENCE: A copy of the training programme sent to the CSCI shows a rolling programme of training including the use of manuals for in house training. Nine of the sixteen care staff had completed the NVQ award and two are just starting. A newer member of staff spoken with said she had received adult protection, health and safety, COSSHE, food hygiene and fire safety training since she started. The staff were relaxed and pleasant but could have been more imaginative in the way they provided prompts to support service users with failing cognitive skills The manager holds staff team meetings to give staff the opportunity to share information and express their views. However, the notes of the last staff meeting in June showed it was poorly attended. Holmfield Court DS0000001466.V306226.R02.S.doc Version 5.2 Page 19 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): 31, 32, 35, 36, 37 and 38 Quality outcomes in this area are good. The judgement is based on all the available evidence, which included pre inspection information, discussion with the manager, staff, service users and visitors, examination of documentation and observation. The proprietor/manager has day-to-day contact with service users therefore is familiar which each person. Supervision was in place but fell short of the minimum six supervisions required in a twelve-month period. The management of personal allowances was safe and orderly making it easy for any service user to see the balance of their personal allowance. Satisfactory systems were in place for health and safety EVIDENCE: The proprietor/manager is nurse trained and holds the NVQ4 award in management. She is the fire trainer for the home and takes responsibility for electrical appliance testing (PAT)
Holmfield Court DS0000001466.V306226.R02.S.doc Version 5.2 Page 20 One person said she had three supervision/appraisals since February 2005 and felt this helped her ‘to learn how to improve’ her practice. All staff must have at least six formal supervisions a year to meet the standards. Any money held on behalf of service users for their immediate needs was held in individual wallets with a clear audit trail showing how the money was spent. It was disappointing to note that some service users were in arrears and having to be subsidised by the home, as the people handling their finances were not providing sufficient weekly personal allowance for their needs. The withholding of finances could be regarded as financial abuse. The manager was advised to add a section about personal allowance to the Statement of Purpose and circulate a letter to all relatives. The fire book was inspected and showed weekly testing of the alarms. The dining room doors were shown not closing on the previous two tests. The manager explained the doors were to be replaced in September. A full fire incident report was written following a mock fire drill and showed staff had followed procedures. The manager is the fire trainer for the home. The communication book is used to record repairs. Ann electrician was checking the home’s wiring at time of visit. The manager does PAT tests on any electrical equipment brought into the home by new service users. Accidents are recorded in accordance with data protection. The manager said that annual building risk assessments are carried out and key-workers check rooms for hazards (the records were not seen.) Holmfield Court DS0000001466.V306226.R02.S.doc Version 5.2 Page 21 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 3 x 3 3 x n/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 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 3 3 3 x 3 4 3 2 STAFFING Standard No Score 27 2 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 x x 3 2 2 3 Holmfield Court DS0000001466.V306226.R02.S.doc Version 5.2 Page 22 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 OP3 Regulation Reg 14(1)(a) (c) Requirement The manager is advised to monitor the quality of information from social workers/hospital staff seeking to place people in the home to ensure it is of a satisfactory standard. Care plans must contain more specific details and be ‘person centred’ to each persons needs. The previous two timescales have not been met. Timescale for action 31/10/06 2 OP7 Reg 15(1) 31/12/06 3 4 OP19 OP26 Reg 23 Reg 16(2)(k) The lock must be repaired on the 31/10/06 w/c door and the ceiling panel in the boiler room must be replaced The odour problem in the 31/10/06 bedroom must be resolved. This is outstanding from the last inspection Staff must have training to develop their skills and knowledge in the care of people with dementia All staff must receive a minimum of 6 formal supervisions each
DS0000001466.V306226.R02.S.doc 5 OP27 Reg 18(1)© Reg 18(2) 31/05/07 6 OP36
Holmfield Court 31/03/07 Version 5.2 Page 23 7 OP37 Reg 17 year. Records must be detailed enough 31/12/06 to show the care provided for each individual 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 OP1 2 3 4 OP12 OP15 OP14 Refer to Standard Good Practice Recommendations The Statement of Purpose could be improved by introducing colour and visual prompts. It is recommended that information about service users’ needs for adequate personal allowances be included in the document. The care plans should place more emphasis on social, recreational and emotional needs More could be done at mealtimes to increase opportunities for conversation, independence and choice. Staff should ensure all service users are aware of their right to make choices about matters concerning their day to day lives and be given the choice to move to a single bedroom when the opportunity arises The garden area should be made secure to allow people with dementia freedom to wander safely 5 OP19 Holmfield Court DS0000001466.V306226.R02.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 Holmfield Court DS0000001466.V306226.R02.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. 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!
