Inspection on 06/06/07 for Holmlea

This inspection was carried out on 6th June 2007.

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 01/12/05

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 Debra Allen Unannounced Inspection 6th June 2007 12:00 Holmlea DS0000027519.V343363.R01.S.doc Version 5.2 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.V343363.R01.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 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.V343363.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Holmlea Address 53a Shipdham Road Toftwood Dereham Norfolk NR19 1JL 01362 854165 NO FAX # lorraine.cornwall@sense.org.uk www.sense.org.uk Sense, The National Deafblind and Rubella Association Miss Lorraine Cornwall Care Home 6 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) Category(ies) of Learning disability (6) registration, with number of places Holmlea DS0000027519.V343363.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st December 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.V343363.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Care Services are judged against outcome groups, which assess how well a provider delivers outcomes for people using the service. The key inspection of this service has been carried out, by using information from previous inspections, information from the providers, the residents and their relatives, as well as others who work in or visit the home. This has included a recent unannounced visit to the home. This report gives a brief overview of the service and the current judgements for each outcome group. This inspection was carried out over a period of three and a half hours, during which time discussions were held with the manager and deputy, a tour of the premises was undertaken and time was spent in one of the communal areas observing interaction between staff and service users. A number of records were also looked at, which included care plans, personnel files and information relating to health and safety within the home. Five questionnaires were returned from relatives, advocates and carers prior to the inspection, all of which were positive and contained comments such as: “I feel the care home does extremely well to meet the individual care needs of its residents.” “I am most satisfied with how things are being done.” “ I think SENSE is doing a wonderful job with all the men and women in their care. Indeed, the change in my son is nothing short of miraculous.” “If I had the authority, I would give medals to all staff and managers. They are great folk doing a difficult job in a very dedicated and unpretentious manner. One recommendations have been made as a result of this inspection. What the service does well: The service user guide was noted to be available in large print, Braille or audio, on request. The staff and management at Holmlea have a very empowering ethos, aiming to support and encourage people to do as much for themselves as is possible in order to reach their own full potential. Holmlea DS0000027519.V343363.R01.S.doc Version 5.2 Page 6 Education and daily programmes are very person centred and tailored to meet individual requirements and there was good evidence of regular community involvement by the service users. The communication profiles are excellent and clear explanations are provided with regard to how and when the person will communicate through facial expressions, vocalisation, sign language or objects of reference. A great deal of thought and effort had been put into creating a truly sensory environment at Holmlea. The manager confirmed that seven care staff have NVQs and a further six are currently working towards their awards. 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. The summary of this inspection report can be made available in other formats on request. Holmlea DS0000027519.V343363.R01.S.doc Version 5.2 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.V343363.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. The organisation has very clear policies and procedures with regard to the referral system for residential placements, including visits and assessments. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All five permanent service users have lived at Holmlea since it opened in 1999. There is currently one temporary service user, for whom a more suitable placement is being sought The organisation’s policies and procedures were looked at and a discussion was held with the manager, which confirmed that service users’ needs are assessed prior to moving in. The Service User Guide was noted to be available in large print, braille or audio, on request. Holmlea DS0000027519.V343363.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 & 10 Quality in this outcome area is excellent. Each service user’s support needs and preferences are reflected extremely well in their care plans and each person is supported to be involved in all aspects of life in the home to the extent that they are able to do so. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two care plans were looked at in detail and each of these contained very clear and comprehensive information with regard to how people wanted and needed to be supported in their daily lives. The contents of the care plans included personal details and history, medical reports, likes and dislikes, mobility and assistive aids and communication profile. It was evident from the information seen that a great deal of time and effort has been spent ensuring clear guidelines are available to enable consistency of care. Holmlea DS0000027519.V343363.R01.S.doc Version 5.2 Page 10 Each care plan also contained risk assessments, which were seen to have been reviewed regularly and updated or amended as necessary. Service users’ information was seen to be stored securely, thereby ensuring confidentiality is maintained. Holmlea DS0000027519.V343363.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 & 17 Quality in this outcome area is excellent. Service users have opportunities for personal development, are part of the local community and engage in appropriate leisure activities. Service users are supported to have appropriate personal relationships. Service users are offered a healthy diet and enjoy their meals and mealtimes. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staff and management at Holmlea have a very empowering ethos, aiming to support and encourage people to do as much for themselves as is possible in order to reach their own full potential. Education and daily programmes were seen to be very person centred and tailored to meet individual requirements. For various reasons, it has been deemed more appropriate for some service users to have ‘home-based’ education rather than attend the day centre. A statement was seen to support Holmlea DS0000027519.V343363.R01.S.doc Version 5.2 Page 12 this, which read: “This programme is to reflect [name]’s interests and provide a routine that will hopefully both stimulate and give opportunities for continual learning. Activities can be adapted on a daily basis to reflect changing needs and wishes. The contents of the education programme included an education timetable and staffing levels, communication profile, current Individual Plan (IP), and ‘homeday’ reports. Some of the activities noted were shopping and life skills, cooking, swimming, tea dances, sailing, bowling, pet care and interaction, choir, pub, reading and listening, music, art and craft, library, letter writing and environmental studies. There was good evidence of regular community involvement and observations and information seen on file confirmed that service users were supported to maintain friendships and family contact. Interaction between staff and service users was observed during the inspection and the staff were heard always speaking respectfully and explaining what they were about to do to service users before they did anything. Lunchtime was observed, which appeared to be an enjoyable occasion. Service users were seen to be involved in the meal preparation and staff provided assistance appropriately and respectfully with regard to eating and drinking whilst encouraging people to be as independent as possible. Menus and food diaries were looked at, which showed a good variety of meals, which were wholesome and nutritious. Evidence was seen of alternatives being offered and provided for all meals during the day, including desserts. Holmlea DS0000027519.V343363.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is excellent. Service users receive personal support in the way they prefer and their physical and emotional healthcare needs are met. Service users are protected by the home’s policies and procedures for dealing with medication. This judgement has been made using available evidence including a visit to this service. EVIDENCE: As described earlier, the care plans that were looked at contained very clear and comprehensive information with regard to how people wanted and needed to be supported in their daily lives and a great deal of time and effort has been spent ensuring clear guidelines are available to enable consistency of care. The communication profiles were excellent and clear explanations were given as to how and when the person will communicate through facial expressions, vocalisation, sign language or objects of reference. Good evidence was seen on file with regard to input and involvement from healthcare professionals such as the doctor, dentist, chiropodist and physiotherapist. Holmlea DS0000027519.V343363.R01.S.doc Version 5.2 Page 14 None of the people living at Homlea are currently self-medicating, but they are protected by the home’s policies and procedures for dealing with medication and staff are well trained in this area. The home uses a Monitored Dosage System (MDS) and the Medication Administration Records (MAR) that were seen were all in order, with no omissions or errors noted. An audit for one person showed all medication to be accounted for. Holmlea DS0000027519.V343363.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. Staff are well trained in areas of adult protection. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There have been no formal complaints since the last inspection. The service users rely very much on staff, family and advocates to raise any issues of concern or make complaints on their behalf and all the staff are well trained with regard to adult protection. Evidence of this was seen in the personnel files, which were looked at on the day. All five people who returned questionnaires stated that they knew how to make a complaint if they needed to and that the home always responded appropriately if any concerns were raised. Holmlea DS0000027519.V343363.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29 & 30 Quality in this outcome area is excellent. Service users live in homely, comfortable and safe environment, which is clean and hygienic. Service users bedrooms, toilets and bathrooms are individual and private and shared spaces complement their individual rooms. Specialist equipment is available and provided if required, to maximise independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Holmlea was found to be clean, hygienic and pleasantly decorated throughout, with a very comfortable and homely atmosphere. The tour of the premises confirmed that the toilets and bathrooms offered sufficient privacy for people using them and service users bedrooms were seen to be very individual and personalised. Holmlea DS0000027519.V343363.R01.S.doc Version 5.2 Page 17 The manager explained how service users are assisted to choose the décor in their rooms and it was evident that a great deal of thought and effort had been put into creating a truly sensory environment, which included a number of walls having been painted with a textured paint. Development work is currently underway in the garden and the manager confirmed plans for a potting shed, raised flower beds and a greenhouse. Various specialist equipment was noted throughout the house. Holmlea DS0000027519.V343363.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is good. Service users are supported by well trained, competent and appropriately qualified staff. The home has robust recruitment policies and procedures and staff receive regular support and supervision. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two staff files were examined and found to contain references and disclosures from the Criminal Records Bureau (CRB). Copies of contracts/job descriptions were also seen on the staff files. Although references are obtained for prospective staff, a recommendation has been made that, in the event of no employment history being available, as a matter of good practice, attempts to obtain character references from professional people such as police, doctors or teachers should be made, rather than from personal or family friends. Holmlea DS0000027519.V343363.R01.S.doc Version 5.2 Page 19 Evidence was available in the personnel files to confirm that staff receive regular training and updates including Moving & Handling, Sign Language, Food Hygiene, Fire Safety, Non Violent Crisis Intervention and Adult Protection. The manager confirmed that seven care staff have NVQs and a further six are currently working towards their awards. Records confirmed that staff receive regular 1:1 support and supervision. Holmlea DS0000027519.V343363.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 41 & 42 Quality in this outcome area is good. Holmlea is a well run home and the service users benefit from the ethos, leadership and management approach. Service users’ views underpin the self-monitoring, review and development of the home. The health, safety and welfare of service users are promoted and protected and their rights are safeguarded by the home’s policies, procedures and record keeping. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has recently completed the registration process with CSCI and appears very settled and competent in her role. Holmlea DS0000027519.V343363.R01.S.doc Version 5.2 Page 21 Health and safety is promoted within the home and records looked at confirmed that fire alarm and safety tests are carried out on a regular basis. Cleaning materials/hazardous chemicals were seen to be stored appropriately in a locked cupboard and staff training in areas relating to health and safety was seen to be up to date. Policies and procedures were looked at and found to be in good order and are regularly reviewed and updated. The area manager carries out the Regulation 26 visits on a monthly basis as required and the results from these have remained positive and consistent with continual improvements to the service as a whole being evident. Holmlea DS0000027519.V343363.R01.S.doc Version 5.2 Page 22 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 4 26 3 27 3 28 3 29 4 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 3 3 LIFESTYLES Standard No Score 11 4 12 3 13 3 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 X 3 3 3 3 3 3 X Holmlea DS0000027519.V343363.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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 YA34 Good Practice Recommendations It is recommended that in the event of no employment history being available, attempts to obtain character references from professional people such as police, doctors or teachers should be made, rather than from personal or family friends. 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