Inspection on 15/06/06 for Holmlea Care Home

This inspection was carried out on 15th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 Care Home 29/04/08

Holmlea Care Home 15/05/07

Holmlea Care Home 24/10/05

Holmlea Care Home 21/10/04

Holmlea Care Home 27/04/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Holmlea Care Home Waverley Street Tibshelf Derbyshire DE55 5PS Lead Inspector Denise Bate Key Unannounced Inspection 15th June 2006 09:15 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 Holmlea Care Home DS0000035767.V294077.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 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. Holmlea Care Home DS0000035767.V294077.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Holmlea Care Home Address Waverley Street Tibshelf Derbyshire DE55 5PS 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) 01773 728600 01773 728605 Derbyshire County Council Patricia Ann Rhodes Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Holmlea Care Home DS0000035767.V294077.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th October 2005 Brief Description of the Service: Holmlea is situated near to the centre of the village of Tibshelf and is next to the local medical centre and pharmacy. The home provides 24 hour personal care and accommodation for 40 older people. The home is a purpose built, single storey building and all residents have single rooms. The design of the home is four separate wings with one wing being used primarily for short term care. The home has pleasant garden and patio areas fully accessible to residents. The home is owned by Derbyshire County Council. Fees are £364 per week for permanent service users, but a range of prices for short term care service users. Holmlea Care Home DS0000035767.V294077.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over six and a half hours. During the inspection 11 service users, and 4 staff members were spoken with. The manager was present during the inspection and provided assistance and information. Written information was provided prior to the inspection. A number of records were examined, including risk assessments and care plans, minutes of meetings, quality assurance information, staff files, medication records and Regulation 26 visit records. An assessment was also made of the progress by the registered persons to address requirements made at previous inspections. Five service users were case tracked. A tour of the part of the building took place. What the service does well: What has improved since the last inspection? Holmlea Care Home DS0000035767.V294077.R01.S.doc Version 5.2 Page 6 Work has been carried out to meet the requirements at the last inspection. One bathroom has been refurbished and is back in use. Temperatures of the medication fridge are being recorded appropriately. Staff files have evidence that the appropriate CRB checks have taken place. A system of individual training records for staff has been introduced. Not all training records are up to date, but it is envisaged that improvements will be made in this area when the management team is fully staffed. 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. Holmlea Care Home DS0000035767.V294077.R01.S.doc Version 5.2 Page 7 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 Holmlea Care Home DS0000035767.V294077.R01.S.doc Version 5.2 Page 8 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): 3, 6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Some care plans relating to personal and social care needs of service users using intermediate care beds were not up to date and did not reflect the high quality of care actually being delivered. This has the potential to place residents at risk. EVIDENCE: The Statement of Purpose and Service User Guide are available in the foyer and at other locations around the home. Copies of assessments for case tracked long term service users were seen on care plan files. The home has two assessment (intermediate care) beds. The inspector was informed that these have been used successfully and enabled some service users to have a period of rehabilitation and this has facilitated a return to their Holmlea Care Home DS0000035767.V294077.R01.S.doc Version 5.2 Page 9 own homes. However, the records seen for two assessment service users indicated that the assessment information did not seem to fully reflect the service users needs, the home had not carried out its own assessment or verification of information prior to admission and no care planning documentation had been drawn up as a result of the assessment. The two service users looked at were admitted back to into hospital, indicating that their discharge may have been premature. Staff spoken to said there was sometimes a lack of information on some assessment service users. Because there was no care plan drawn up from the assessment, it was not possible to ascertain what support from the community services was planned. Detailed daily logs had been kept by care staff which indicated where difficulties had occurred. The inspector was informed that regular reviews take place. Holmlea Care Home DS0000035767.V294077.R01.S.doc Version 5.2 Page 10 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, 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Some care plans relating to personal and social care needs of service users were not up to date and did not reflect the high quality of care actually being delivered. This has the potential to place residents at risk. EVIDENCE: All service users spoken to praised the staff and felt they were provided with a high standard of care and that their individual needs and preferences were respected. Five service users were case tracked and care planning documentation was seen for two service users who had occupied assessment beds. Some care planning documentation was excellent, with detailed and informative personal service plans indicating service user preferences and with evidence of regular reviews. Some of the assessment and care planning documentation was not up to date, had not been signed or completed and Holmlea Care Home DS0000035767.V294077.R01.S.doc Version 5.2 Page 11 there was no evidence of regular reviews, or the review was filed in the wrong place. Some files had completely blank forms on them. Some care plans were incomplete and did not give sufficient detail as to how residents’ care should be provided. Daily logs were generally detailed and informative. As indicated previously, care plans had not been drawn up for two service users who had occupied the assessment beds. Where personal service plans had been completed and were up to date, the health needs of service users were fully recorded. The inspector was informed that only one service user manages their own medication. Medication administration records for case tracked service users was up to date. There was no record of staff signatures in the medication administration folder. The home did not have a copy of the latest advice from the Royal Pharmaceutical Society. The dispensing pharmacist visits the home regularly. The inspector was informed that all staff dispensing medication had appropriate training. The medication fridge temperatures were recorded. The date of opening was not recorded on eye drops. Night staff only dispense homely remedies where appropriate. Derbyshire County Council has an equal opportunities policy. As indicated previously, service users preferences and care needs (including encouraging service users to be independent) were noted in detail on some care planning documents. There were displays of photographs and other memorabilia around the communal spaces of the home which reflected the cultural background of the area as a mining community. Holmlea Care Home DS0000035767.V294077.R01.S.doc Version 5.2 Page 12 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, 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Activities are provided that suit the expressed preferences of service users. Regular outside contacts are encouraged and supported. This assists in contributing to a pleasant atmosphere and the overall high level of satisfaction for service users. Dietary needs of service users are well catered for with a balanced and varied selection of food available that meets service users’ tastes and choices. EVIDENCE: This area had been highlighted for development by the previous quality assurance exercise and plans had been implemented for improvements. Regular activities include movement and music, outings in the summer, in house entertainment, bingo, crafts, gardening, ‘Kingfisher club’ and themed events, e.g. Easter, etc. Details of forthcoming events, photographs of previous outings and events, and other information useful to service users and relatives/friends are displayed around the home. Service users interviewed Holmlea Care Home DS0000035767.V294077.R01.S.doc Version 5.2 Page 13 reported that they felt the home provided suitable activities and catered for their interests. On the day of inspection the hairdresser was visiting the home, some service users were having their nails done, an organist provided afternoon entertainment, and preparations were being made to watch England’s world cup football match. Outings are arranged and service users are sometimes accompanied by relatives. Some service users prefer to spend time on their own, and this is respected. There is a regular residents meeting and the minutes of the last meeting were made available. These were well attended and indicated that service users were given the opportunity to give their views on a variety of topics relating to the day to day running of the home. The home have contacts with the local community groups, including the local church and services are held at the home regularly. It was confirmed by service users that visitors to the home are welcomed, although no relatives were seen on this inspection. Most service users have regular contact with relatives and friends and some go out on a regular basis. Service users indicated that they feel staff are approachable and any problems can be discussed with them or with one of the managers. All indicated that they are able to exercise choice about aspects of their daily lives, and this was reflected in some care planning documentation. All service users spoken to were extremely complimentary about the standard of catering, and the choice of menus that are available. Holmlea Care Home DS0000035767.V294077.R01.S.doc Version 5.2 Page 14 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, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are systems in place which promote the protection of service users from abuse and neglect. A complaints procedure is in place. EVIDENCE: There is a corporate complaints procedure in place, although most relatives and service users prefer to raise issues on a more informal basis. The manager and staff are viewed as approachable and responsive. There had been no formal complaints recorded. Derbyshire County Council has clear procedures for dealing with the safety of service users and protecting them from harm. Staff spoken to had had training in the protection of vulnerable adults and showed an awareness of adult protection issues and would pass any concerns on to their line manager. Holmlea Care Home DS0000035767.V294077.R01.S.doc Version 5.2 Page 15 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, 23, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment within the home is generally well maintained and provides service users with an attractive and homely place to live. EVIDENCE: The home is arranged into 4 wings, each with their own bathrooms, and lounge/dining area. Service users are able to smoke on one wing, and it was noted that the home did attempt to meet all service users preferences in respect to these arrangements. The building has been maintained to a reasonable standard overall, and the decoration and refurbishment of the bathroom has improved the facilities for service users. There is a rolling programme for maintenance and redecoration and new carpets curtains and furniture have been ordered for some lounges. Some new lights were being installed on one corridor, and the decoration needs to be ‘made good’ in due Holmlea Care Home DS0000035767.V294077.R01.S.doc Version 5.2 Page 16 course. Bedrooms are personalised according to service users preferences, and were bright and airy. Service users had chosen their own decoration. Some toilets and bathrooms were seen and found to be satisfactory. There are garden areas where service users can sit in fine weather. The home takes pride in its garden, and service users were involved in the planting up of flower beds and containers. The exterior of the building was satisfactory and the home was decorated with several attractive mosaics and a welcome notice. Holmlea Care Home DS0000035767.V294077.R01.S.doc Version 5.2 Page 17 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, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A trained and competent workforce are in place which meet the dependency needs of service users currently accommodated within the home. EVIDENCE: The staff rotas were discussed and found to provide adequate staffing to meet service users’ needs at the current time, although staff were often very busy. The manager said that staff worked constructively together and worked as a team. Staff spoken to were responsible, enthusiastic and competent. They were observed being responsive to service users’ needs during day to day tasks. Staff said they felt supported by both their colleagues and their managers, and felt that they were offered good training opportunities. Induction training had taken place (although in one instance this had not yet been recorded on the individual training plan), including shadowing more experienced staff, and this was seen as helpful and contributing to staff job satisfaction. Holmlea Care Home DS0000035767.V294077.R01.S.doc Version 5.2 Page 18 Staff files seen had evidence of CRB checks, copies of contracts and references. Derbyshire County Council has a thorough and detailed recruitment and selection procedure. Holmlea Care Home DS0000035767.V294077.R01.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, 33, 35, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff demonstrate an awareness of their roles and responsibilities ensuring that the home is run in the best interests of the service users. EVIDENCE: The manager has the required qualifications and experience to fulfil the responsibilities of her role. Service users and staff commented on how they found the manager to be approachable and felt that she was supportive. There has been one full time deputy post vacant and this has recently been filled. As has been noted previously in this report, some aspects of recording are not up to date and it is envisaged that this will be remedied when all deputy managers are in post and able to take responsibilty for their aspect of the day to day running and management of the home. Holmlea Care Home DS0000035767.V294077.R01.S.doc Version 5.2 Page 20 The information provided by the manager prior to inspection indicates that the home makes every effort to ensure safe working systems are in place and equipment maintained satisfactorily. There is a routine rolling programme for minor repairs and decoration. Regulation 26 visits take place and copies were made available to the inspector. Formal regulation 26 reports were only done every three months, although it was noted that the service manager came to the home for reviews and to supervise the manager, and so was visiting on a monthly basis. Details of the quality assurance results are prominantly displayed and a formal plan has been drawn up to address issues raised. There are regular residents meetings and the minutes indicated that they are well attended and matters related to the day to day running of the home are discussed. The inspector was informed that the home is moving towards a computerised system for managing service users’ finances. At present residents finances are kept in the safe and manual records kept, which appears to work satisfactorily. Holmlea Care Home DS0000035767.V294077.R01.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 X X 3 X X 1 HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 2 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 x 18 3 3 3 3 X 3 X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Holmlea Care Home DS0000035767.V294077.R01.S.doc Version 5.2 Page 22 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. 1. Standard OP6 Regulation 15 Requirement Full and detailed assessments and care plans must be drawn up for service users occupying assessment beds. Care planning documentation should be reviewed and, where appropriate, updated and completed to ensure consistency. A record of staff signatures must be kept to verify medication administration records. Decoration must be carried out where new lights have been put in. The planned programme of replacing furniture, carpets and curtains must be carried out. A plan to carry out electrical work identified in the recent hard wiring survey must be carried out. Timescale for action 30/07/06 2. OP7 15 30/09/06 3. 4 5 6 OP9 OP19 OP19 OP38 13 (5) 23 (2) (b) 23 (2) (b) 23 (2) (b) 30/07/06 30/09/06 30/09/06 30/09/06 Holmlea Care Home DS0000035767.V294077.R01.S.doc Version 5.2 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP9 OP33 Good Practice Recommendations The date of opening should be put on eye drops. Regulation 26 reports should be done monthly. Holmlea Care Home DS0000035767.V294077.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Care Home DS0000035767.V294077.R01.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!