Inspection on 01/12/05 for Holmlea

This inspection was carried out on 1st December 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Holmlea 06/06/07

Holmlea 19/05/05

Holmlea 18/01/05

Holmlea 29/06/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Holmlea 53a Shipdham Road Toftwood Dereham Norfolk NR19 1JL Lead Inspector Mr Roger Andrews Announced Inspection 1st December 2005 02:00 Holmlea DS0000027519.V262227.R01.S.doc Version 5.0 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 Holmlea DS0000027519.V262227.R01.S.doc Version 5.0 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 Adults 18-65. 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. Holmlea DS0000027519.V262227.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Holmlea Address 53a Shipdham Road Toftwood Dereham Norfolk NR19 1JL 01362 854165 NO FAX # shipdam53@btconnect.com www.sense.org.uk Sense East 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) Mrs Abigail Hewitt Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Holmlea DS0000027519.V262227.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th May 2005 Brief Description of the Service: Holmlea is a purpose built home. It provides a domestic living environment for five adults with learning difficulties who have sensory and physical impairments (deaf/blind). The communal and bedroom accommodation for service users are located on the ground floor. There are five single rooms on the ground floor, each of which has a joint shared full en suite facility, There is access for wheelchairs in all parts of the home. The accommodation is of a high quality, which enables residents the opportunity to lead fulfilled lives. There is car parking at the front of the home and there is a garden to the rear. The home forms part of the residential provision, provided by Sense, the national Deaf/Blind and Rubella Association. Holmlea DS0000027519.V262227.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced. It covered the key standards, (the standards that the Commission think should be looked at each year), not covered at the last inspection, which was unannounced. A number of records were looked at and staff and residents were chatted with. As the residents have limited verbal communication quite a lot of evidence was gained by observing them relaxing and being helped by the staff. Since the previous inspection there have been no complaints received by the Commission about Holmlea. The Commission’s view is that this is a well run service. What the service does well: What has improved since the last inspection? What they could do better: The only suggestion made in this report is that where the staff have to sign any documents, (about the support residents need), to show that they have read them, that this is followed up to make sure everyone does this. Holmlea DS0000027519.V262227.R01.S.doc Version 5.0 Page 6 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. Holmlea DS0000027519.V262227.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Holmlea DS0000027519.V262227.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not inspected on this occasion. EVIDENCE: There have been no recent admissions. Sense have a detailed admission process to identify suitable candidates for particular resources. The residents have lived at Holmlea since it opened. There is one temporary resident for whom a more suitable placement is currently being sought Holmlea DS0000027519.V262227.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6&7 Care plans give an excellent picture of each resident’s support needs and preferences. The staff support residents to be involved in their day to day lifestyle to the extent they are able. EVIDENCE: Each resident has an individual care plan folder. Three of these were looked at. Each contained an excellent description, written in the first person, of each resident. Descriptions highlighted how they needed to be supported with specific tasks with guidance such as, “I am quite capable of walking on my own upright, but I like you to support me by holding my hand”. The assistance residents required with, for example bath times and mealtimes, is recorded in great detail and the way that each resident prefers to be communicated with is set out clearly. This includes vocalisation, touch and objects of reference. Care plans reflect weekly programmes for each resident including leisure and work activities. Health care needs are documented. Aspects such as weight, fluid intake and sleep are recorded if required. Holmlea DS0000027519.V262227.R01.S.doc Version 5.0 Page 10 Risk assessments are in place. There are detailed comments on challenging behaviour and the need for any physical intervention. Any issues raised in these areas can be overseen by Sense’s regional specialist. Areas of concern where residents need help are also included in the detailed descriptions referred to above. The files give a good understanding of each resident’s support needs and preferences and must be especially helpful to new staff in reinforcing verbal guidance offered to them. The only shortfall observed was that staff are asked, in some instances, to sign guidance documents to indicate they have read them. These are not completed in all cases and this needs to be followed up. See recommendation. However, the overall standard of these files is very good and this has been a consistent finding at previous inspections. A simplified version of the care plans is going to be produced in audio tape format. Holmlea DS0000027519.V262227.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13, 15, 16 & 17 Residents have interesting and varied programmes and have a good level of involvement in their local community with the support of the staff. Residents are involved in mealtimes and food preparation. The menu is varied. EVIDENCE: The residents have active outside programmes which includes trips into town, pubs, day time activities at their local day services centre. They also have a home day where they can work individually with staff and/or go shopping or on an outing. The local town centre is accessible by wheelchair and staff will assist residents to participate in a wide range of community based activities. Examples include banger racing, theatre trips, swimming, football and line dancing. Where they wish, the parents are fully able to be involved. This includes visiting residents at Holmlea and residents going home for visits and short stays. Holmlea DS0000027519.V262227.R01.S.doc Version 5.0 Page 12 The comments in care plans reflects very clearly that staff have taken into account the things that residents prefer and what they can do for themselves. This was reinforced by observations during the inspection when watching the interaction between staff and residents. The staff always explain to residents what they are going to do and explain if, for example, they have to move away to get something. Residents are fully included in house conversations and there is never a feeling that the conversation is excluding them. The detailed care notes and the interaction between staff and residents gives a reassuring sense that residents’ views and preferences are incorporated as far as possible in how they are supported despite their inability to vocalise these views. This includes when they want to relax, where they want to relax and when they want to be involved. Examples of these things were observed. Residents eat together with staff and receive appropriate help at the table, and are encouraged to use as eating utensils independently. If possible the food is freshly cooked and there is a varied menu. Residents will be involved in cooking by staff informing them of what they are cooking, being able to smell foods as they are being prepared and in helping directly with meal preparation. Residents were briefly observed having their evening meal. The kitchen/dining area is very much a focal point of the home and has a warm and inviting feel to it. Holmlea DS0000027519.V262227.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 & 19 Personal support is offered in a sensitive manner and reflects that way residents’ want to be helped. EVIDENCE: The way in which personal care is delivered is set out clearly in the care plans and reflects health care issues and input by G.P.s and other specialists. The staff have access to specialist advice within the organisation as well as external sources. Specific conditions such as epilepsy are documented and have management protocols in place which staff have signed to indicate they have read these. From observations on this and previous occasions, the way in which residents are assisted with personal care, such as using the toilet, shows that the staff take steps to protect residents’ privacy. Holmlea DS0000027519.V262227.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Staff are kept up to date with adult protection issues and protocols. EVIDENCE: Residents rely on others, staff and family or friends, to highlight complaint issues. However, there is a good sense that staff are very aware of the residents’ rights and how they should be treated, both in Holmlea and in the wider community. In the previous report mention was made to the adult protection questionnaire which staff were completing. This process has now been concluded and an example of a questionnaire and feedback were viewed. Staff have to submit their questionnaires to a regional officer. They receive an indication as to whether they have achieved a satisfactory standard and they receive written feedback. This exercise is going to be repeated annually with different questions for staff. This is an excellent addition to any periodic training on this topic and is commended. Holmlea DS0000027519.V262227.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 The home offers a pleasant domestic environment and is clean. EVIDENCE: These standards were looked at in the previous inspection. The building is purposed designed and in good order. The only additional point to make on this occasion is that the interior requires a programme of re-decoration as walls have become scuffed and marked, due to the frequent use of wheelchair and other equipment. The manager reported that this was planned for the new year so a recommendation is not made on this occasion. No obvious hazards were noted and the home looked clean and was odour free. Holmlea DS0000027519.V262227.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35 & 36 Supervision is in place for all staff. NVQ training is well underway. EVIDENCE: Seven staff have now completed their NVQ training. Eight staff are currently undertaking NVQ training. The manager and the deputy manager are undertaking NVQ 4. The deputy manager is an NVQ assessor. A recently appointed member of staff was talked with. She confirmed participating in the organisation’s induction training programme and undertaking observational shifts prior to commencing official duties. She will be doing medication training in January 2006 and does not currently administer any medication. Supervision is in place and the new member of staff confirmed that she had received formal one to one supervision. She was aware that this would take place every four to six weeks. Holmlea DS0000027519.V262227.R01.S.doc Version 5.0 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 41 & 42 The records viewed were up to date. The organisation carries out its own internal checks. EVIDENCE: The fire records were examined. Tests and records are up to date. The Fire Officer visited on 6th September 2005 and no issues were raised by him. The fire system was serviced in July 2005. The fire risk assessment is updated annually, a process carried out by the regional health and safety officer. Staff have been provided with a training DVD by their regional officer. Staff have to undertake refresher fire training every six months. Night staff have to undertake this every three months. The residents’ finances were not checked on this occasion. However, Sense has carried out a full financial audit of these documents from January 2003 to April 2005. Bank statements are audited by the manager every month and the residents’ financial records are checked every week. Holmlea DS0000027519.V262227.R01.S.doc Version 5.0 Page 18 Appropriate liability insurance is in place. The certificate is displayed in the office. Holmlea DS0000027519.V262227.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 4 3 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X X X X 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Holmlea Score 3 3 X X Standard No 37 38 39 40 41 42 43 Score X X X X 3 3 X DS0000027519.V262227.R01.S.doc Version 5.0 Page 20 No 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA6 Good Practice Recommendations It is recommended that where staff are required to sign documents that a system is in place for ensuring this takes place within an acceptable timeframe. Holmlea DS0000027519.V262227.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Holmlea DS0000027519.V262227.R01.S.doc Version 5.0 Page 22 - 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. 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