Inspection on 19/05/05 for Holmlea

This inspection was carried out on 19th May 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 01/12/05

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 NR19 1JL Lead Inspector Roger Andrews Unannounced 19 May 2005 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 I55 S27519 Holmlea V227984 190505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Holmlea Address 53a Shipdham Road, Toftwood, Dereham, Norfolk, NR19 1JL 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) 01362 854165 Sense East Mrs Abigail Hewitt Care Home 5 Category(ies) of LD Learning disability registration, with number of places HOLMLEA I55 S27519 Holmlea V227984 190505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18 January 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 I55 S27519 Holmlea V227984 190505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place at 2pm in the afternoon. Some of the residents were initially at their day services and returned during the course of the afternoon. Files and records were viewed. A tour of the home was undertaken and discussion took place with the deputy manager and a member of staff. Residents were observed and chatted to informally, but were not interviewed due to verbal communication difficulties. What the service does well: What has improved since the last inspection? What they could do better: The home was operating in a relaxed fashion. In relation to the things that the inspector looked at on this visit there are no matters that need following up by the home. HOLMLEA I55 S27519 Holmlea V227984 190505 Stage 4.doc Version 1.30 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 I55 S27519 Holmlea V227984 190505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection HOLMLEA I55 S27519 Holmlea V227984 190505 Stage 4.doc Version 1.30 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 standard(s) These standards were not inspected on this occasion. EVIDENCE: HOLMLEA I55 S27519 Holmlea V227984 190505 Stage 4.doc Version 1.30 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 standard(s) 9 Risk assessments are in place. These are used to support residents in joining in a wide range of everyday activities and sports on a regular basis. EVIDENCE: A new risk assessment file is currently under development. This will bring relevant information together for easy access by staff. Risk assessments are in place on each resident’s file. These include both in-house and outside of the house assessments such as using kitchen utensils, making hot drinks, using stairs and travelling in the car. There are examples of residents being able to take risks under supervision such as using knives to help in food preparation, shopping, going swimming, and horse riding. The risk assessments indicate the required staffing levels for residents when engaging in particular activities. HOLMLEA I55 S27519 Holmlea V227984 190505 Stage 4.doc Version 1.30 Page 10 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 standard(s) 12 Residents have a full and interesting activity programme and are encouraged and enabled to participate irrespective of their level of disability. EVIDENCE: Each resident has a weekly programme consisting of day services, (Sense operate their own day centre a short trip from Holmlea), and residents also have a home day where they can focus on domestic and leisure activities. A wide range of social and sporting activities take place on a regular basis during the day, in the evenings and at weekends. An activities folder is maintained. In addition to examples mentioned earlier in this report other activities include banger racing, cycling, tobogganing, (at Norwich Ski Slope), and going to the pub. There is also a sensory room where residents like to spend time relaxing. An achievement record is also maintained. This records progress made by residents in a variety of tasks such as making a hot drink or recognition of a picture/symbol. HOLMLEA I55 S27519 Holmlea V227984 190505 Stage 4.doc Version 1.30 Page 11 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 standard(s) 20 Medication is securely stored and properly administered. Staff are trained in the handling of medication. EVIDENCE: The daily administration record of medicines was checked and the records available were up to date. Some MAR sheets accompany residents to their day services and are returned in the evening. Medication is securely stored in a purpose built cabinet which is locked inside a store cupboard. Sample initials and signatures are kept making it easy to identify initials on medication records. A returned medication record is kept. A record of the start date of each medication is also maintained. A monitored dosage system is in place. G.P. consultations are logged in the medication file. A member of staff reported that she had undertaken training in handling medication as part of her induction. She had also undertaken the Boots medication course. A medication policy is in place. This is one of the policies located in the ‘Policies of Priority’ folder which staff are being encouraged to review and update themselves on, (and sign when they have done so). This folder contains key policies with a view to making them more accessible to staff. HOLMLEA I55 S27519 Holmlea V227984 190505 Stage 4.doc Version 1.30 Page 12 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 standard(s) 23 Staff are aware of and receive training about responding to situations where use may have occurred. EVIDENCE: A policy on adult abuse and protection is in place. Staff are currently completing a questionnaire dealing with adult abuse issues. A completed example of a questionnaire was produced. It asks staff to say how they would respond to a number of potentially abusive scenarios. The responses are then being followed up with staff individually at their next supervision session. This type of training is commended. All staff have just completed a refresher course dealing with gender issues, intimate care and attitudes. A member of staff confirmed that intimate personal care is given by staff members of the same gender as the resident. HOLMLEA I55 S27519 Holmlea V227984 190505 Stage 4.doc Version 1.30 Page 13 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 standard(s) 24, 25 27 & 30 Holmlea provides a homely and clean environment for residents. EVIDENCE: Holmlea is a purpose built house that is domestic in style. It has an enclosed garden to the sides and rear of the home. The residents’ accommodation is on the ground floor, although one able bodied resident is temporarily living in a bedroom on the first floor whilst alternative accommodation is sought. Furniture and furnishings are comfortable and homely. Sizeable bathrooms and toilet facilities are available including appropriate equipment for moving residents. Bathrooms are also personalised with mobiles and ornaments to add a more homely feel to them. Bathrooms have locks. Each resident’s bedroom exhibited a high degree of personalisation and reflected personal interests such as football, (e.g. posters). Eye catching mobiles and wall decorations have been added. One resident has a musical beanbag. The home appeared clean, was free from unpleasant odours and no obvious safety hazards were noted. A laundry room is located on the ground floor and HOLMLEA I55 S27519 Holmlea V227984 190505 Stage 4.doc Version 1.30 Page 14 this includes a sluice facility. Washing machines have a sluice programme and soiled materials are stored separately to others whilst awaiting washing. HOLMLEA I55 S27519 Holmlea V227984 190505 Stage 4.doc Version 1.30 Page 15 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 & 34 The recruitment process meets the expectations of legislation. Sufficient staff are on duty to meet the needs of the residents allowing for one to one attention when required. EVIDENCE: Four staff were on duty at the time the inspection took place and four were scheduled to be on duty during the evening period until 10pm. Two members of staff are present during the night, one waking and one sleep-in. Two staff files were examined. These contained completed application forms, two written references, evidence of identity, a contract of employment and relevant Criminal Records Bureau checks. HOLMLEA I55 S27519 Holmlea V227984 190505 Stage 4.doc Version 1.30 Page 16 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not inspected on this occasion. EVIDENCE: HOLMLEA I55 S27519 Holmlea V227984 190505 Stage 4.doc Version 1.30 Page 17 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 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x 3 x x 3 Standard No 11 12 13 14 15 16 17 x 3 x x x x x Standard No 31 32 33 34 35 36 Score x x 3 3 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 HOLMLEA Score x x 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x x x I55 S27519 Holmlea V227984 190505 Stage 4.doc Version 1.30 Page 18 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. Standard Regulation None 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 None Good Practice Recommendations HOLMLEA I55 S27519 Holmlea V227984 190505 Stage 4.doc Version 1.30 Page 19 Commission for Social Care Inspection 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. 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