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Inspection on 15/05/07 for Holmlea Care Home

Also see our care home review for Holmlea Care Home for more information

This inspection was carried out on 15th May 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Holmlea provides a comfortable, homely, and relaxed environment for residents. Residents and relatives spoken with made positive comments about the home and staff; `the staff are good`; `we are well looked after here`, ` I can`t fault the staff`. Communal areas of the home are comfortable and provide a range of areas for residents to use. The home was found to be generally well maintained and clean throughout. The food was said to be `very good` and quality was praised by all residents and relatives spoken with. Staff spoken to were experienced, knowledgeable, and committed to the welfare of residents. There is a stable staff group and two vacancies have recently been filed. Staff supervision takes place and training is given a high priority. Most care staff are trained to NVQ level 2. There is a robust system for recruiting and training new staff and appropriate checks are carried out. There is a corporate complaints procedure, although most day to day difficulties are dealt with on an informal basis. There is a clear safeguarding adults procedure and staff have received appropriate training. An independent quality assurance exercise found that the overall quality of care was rated as `good` or `excellent` by residents and their advocates.

What has improved since the last inspection?

Work has been done to improve care planning documentation. The home are currently implementing the new computer based `Framework I` system which will be used by all Derbyshire County Council staff. Requirements made at the last inspection have been carried out; a record of staff signatures is kept (and all managers have had a formal assessment of their medication practices), redecoration had been carried out, and there is a planned programme for replacing furniture, carpets and curtains and various rooms in the home, e.g. communal lounge, have been upgraded. It was noted that the recently appointed service manager is now providing regular support to the home including Regulation 26 visits. A number of new local initiatives are in the process of being set up including a local manager group to meet and exchange ideas and support, and the intermediate care bed arrangements are being renegotiated.

What the care home could do better:

Work must continue to transfer personal service plans onto the new system and ensure that all risk assessments are completed in detail. A number of good practice recommendations have been made including; formally monitoring residents` dependency levels, looking at ways to enable staff to provide more `one to one` time with residents, holding regular staff meetings, setting up a new system of staff training records and providing dementia training for care staff.

CARE HOMES FOR OLDER PEOPLE Holmlea Care Home Waverley Street Tibshelf Derbyshire DE55 5PS Lead Inspector Denise Bate Key Unannounced Inspection 15th May 2007 09:30 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.V337445.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.V337445.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 www.derbyshire.gov.uk 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.V337445.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th June 2006 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 £381.84 per week for permanent residents, but a range of prices for short term care residents. Additional charges, e.g. hairdressing, chiropody, are clearly identified in the home’s Statement of Purpose and Service User Guide. Copies of inspection reports are available in the foyer. Holmlea Care Home DS0000035767.V337445.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 hours. During the inspection seven residents, three relatives, and four staff members were spoken with. Some residents were on an outing on the day of inspection, but a cross section of residents were spoken with, including long stay and day care residents. The manager, service manager and a deputy manager were present during the inspection and provided assistance and information. Prior to the inspection a number of sources of information were looked at including the home’s service record and previous inspection reports. A number of records were examined on the day of inspection, including care planning documentation, minutes of meetings, regulation 26 visit records, staff files and medication records. Three residents were case tracked and care planning documentation and files for other residents were seen. A tour of the building took place and the grounds were seen. What the service does well: Holmlea provides a comfortable, homely, and relaxed environment for residents. Residents and relatives spoken with made positive comments about the home and staff; ‘the staff are good’; ‘we are well looked after here’, ‘ I can’t fault the staff’. Communal areas of the home are comfortable and provide a range of areas for residents to use. The home was found to be generally well maintained and clean throughout. The food was said to be ‘very good’ and quality was praised by all residents and relatives spoken with. Staff spoken to were experienced, knowledgeable, and committed to the welfare of residents. There is a stable staff group and two vacancies have recently been filed. Staff supervision takes place and training is given a high priority. Most care staff are trained to NVQ level 2. There is a robust system for recruiting and training new staff and appropriate checks are carried out. There is a corporate complaints procedure, although most day to day difficulties are dealt with on an informal basis. There is a clear safeguarding adults procedure and staff have received appropriate training. An independent quality assurance exercise found that the overall quality of care was rated as ‘good’ or ‘excellent’ by residents and their advocates. Holmlea Care Home DS0000035767.V337445.R01.S.doc Version 5.2 Page 6 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 Care Home DS0000035767.V337445.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.V337445.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information is available to ensure residents can make an informed choice about where they live. EVIDENCE: Copies of the Statement of Purpose and the Service User Guide are available in all residents’ rooms. On the day of inspection some residents were on a day trip and the inspector was unable to talk to any residents who had recently come to the home. However, some permanent residents have got to know the home through the provision of day care and/or short term care. Prospective residents or their Holmlea Care Home DS0000035767.V337445.R01.S.doc Version 5.2 Page 9 advocates are encouraged to visit prior to making a decision to move to the home. Copies of the home’s assessments were seen on care planning documentation of case tracked residents, as were copies of assessments provided by social services staff. It was noted that the new computer based system will aid the availability of up to date information to assist in provided appropriate care for residents. At the last inspection it was noted that there were some problems with the intermediate care beds as information and support given was not always adequate to meet residents needs and ensure residents were appropriately placed. The home is in the process of renegotiating the terms of the intermediate care beds, none were being used on the day of inspection, so standard 6 was not assessed on this occasion. The inspector was informed that the Statement of Purpose and Service User guide will be updated when the intermediate care beds become operational. Holmlea Care Home DS0000035767.V337445.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are completed and are individualised to demonstrate that residents’ health, personal and social care needs are being met. EVIDENCE: A great deal of work has been done since the last inspection to improve care planning documentation. Three case tracked residents had clearly arranged care planning documentation. Items in files included monthly reviews, personal service plans, risk assessments (moving and handling, nutrition), weight monitoring, and detailed day to day logs. Personal service plans were clearly written and resident focussed and individualised e.g. including food preferences, night time checking arrangements, personal routines, etc. Holmlea Care Home DS0000035767.V337445.R01.S.doc Version 5.2 Page 11 One risk assessments seen had not been completed in sufficient detail to provide advice and guidance to staff. This was discussed with the manager. It is understood that training has recently been given and the home are to review their moving and handling risk assessments. An assessment for a resident who uses the Wanderguard system needed to be done in more detail to provide written evidence that the system was appropriate to the resident. As mentioned previously, the home are in the process of introducing a computer based care recording system, Framework I, which was shown to the inspector. It is envisaged that within the next six months all personal service plans will have been transferred to the new system. Copies of reviews will also be held on this system. There was evidence in the current care planning system that care plans were reviewed regularly. Relatives and residents referred to meetings that were held to review care. Personal service plans had been signed by residents, indicating that their contents had been discussed with them. For each resident a second care file contains financial information and background details and copies of assessments and care plans that have been superseded. Copies of contracts were available for some residents and these are in the process of being updated. Copies of financial information provided to residents and/or their advocates is available on the new computer system, and this was made available to the inspector. Derbyshire County Council has a clear policy relating to equality. Staff were observed supporting and reassuring residents. Residents and relatives said the staff were ‘good’ and they were treated with dignity and respect; ‘the staff are always happy’, ‘staff here are very good’. Staff spoken to related to residents as individuals. Most residents are local and reflect the cultural background of the community, which was a mining area. There is a display of mining memorabilia in one of the corridors. Aspects of residents’ health needs and medication were clearly presented on care planning documentation. Residents are supported to go to hospital appointments. Staff spoken to had a good knowledge of residents health care needs. The home uses the NOMAD system for medication, and some medication is kept in original packaging. There is a separate medication room where medication is kept securely. Pictures of residents are kept with their medication administration records, reducing the possibility of residents being given the wrong medication. The deputy manager explained the system of medication administration, which had been developed in line with specialist advice. One resident self medicates. The records were seen and found to be satisfactory, and there had been an appropriate assessment carried out by staff. The medication records of some case tracked residents were seen and Holmlea Care Home DS0000035767.V337445.R01.S.doc Version 5.2 Page 12 found to have been recorded correctly. The date of opening had been recorded on eye drops and creams. The fridge temperatures were being monitored. The home have access to medication leaflets to provide information about particular drugs and their uses and side effects. The home are working to ensure all aspects of the home’s practice are in line with current Derbyshire County Council guidelines. A record is kept of staff signatures. Holmlea Care Home DS0000035767.V337445.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. 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. The home provides suitable activities and the quality of catering is good which contributes to a pleasant atmosphere and the overall levels of satisfaction for residents. EVIDENCE: There is an activities organiser and records are kept of activities undertaken. On the day of inspection residents went on an outing. Regular events include playing bingo, in house entertainment, movement to music, craft, and seasonal events e.g. Easter had recently been celebrated. Preparations were being made to work on the garden and the home have won prizes in previous years. A residents meeting had been held recently which discussed preferences regarding future events. Activities are regularly reviewed by the service manager during regulation 26 visits. Holmlea Care Home DS0000035767.V337445.R01.S.doc Version 5.2 Page 14 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 residents and relatives that visitors to the home are welcomed. Most residents have regular contact with relatives and friends and some go out on a regular basis. Relatives said that the home was ‘wonderful’, ‘you only need to mention something and it’s done’. Regular reviews are held where residents ‘can say what they think’. Good communication was reported with the home who always keep relatives informed of any issues or problems. Relatives felt that the home physical environment was good as it was spacious, there was a choice where and how residents spent their time, and the lounge/dining areas were ‘homely’. Staff spoken to were aware of residents needs and preferences and these were also reflected in care planning documentation. However, it was felt that that residents would benefit from ‘one to one’ with staff. Meals are served in the lounge/dining areas on the wings. All residents and relatives spoken to were extremely complimentary about the standard of catering, and the choice of menus that are available. The inspector took lunch and it was of a good quality. Holmlea Care Home DS0000035767.V337445.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. 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. Clear and accessible complaints and safeguarding adults procedures are in place to ensure residents can be confident that any issues raised would be acted on effectively and promptly. EVIDENCE: There is a corporate complaints procedure, although most relatives and residents prefer to raise issues on a more informal basis. The complaints procedure is displayed in the foyer and is in the Statement of Purpose and Service User Guide. No complaints have been made to the home or to CSCI. Residents and relatives told the inspector they had ‘no complaints’ Derbyshire County Council has clear procedures for dealing with the safety of residents and safeguarding them from harm. Staff spoken to showed an awareness of safeguarding adults issues, were clear about their responsibilities and would pass any concerns on to their line manager. Training in safeguarding adults has been provided for staff. Holmlea Care Home DS0000035767.V337445.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 24, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides residents with an attractive and homely place to live. EVIDENCE: The home is arranged into 4 wings, each with its own bathroom and lounge/dining area. Residents 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 good standard overall. There is a rolling programme for maintenance and redecoration and new carpets, curtains and Holmlea Care Home DS0000035767.V337445.R01.S.doc Version 5.2 Page 17 furniture have improved facilities in the lounges. Some new lights have installed in corridors. Residents spoken to were happy with their bedrooms. Bedrooms are personalised according to residents’ preferences. There are some larger bedrooms available to enable equipment to be used to assist in the care of residents with physical disabilities. Some bedroom furniture could be replaced, and some bedrooms doors need revarnishing. It is understood that this is planned as part of the rolling maintenance programme for the current year. Some toilets and all the bathrooms were seen and found to be satisfactory. There are attractive garden areas where residents can sit in fine weather. The home takes pride in its garden, and residents are involved in the planting up of flower beds and containers. The home have gained prized in a gardening competition, and hope to compete again this year. The grass needed cutting on the day of inspection, but the manager said that this was now due and that usually the service provided was satisfactory. The home was decorated with several attractive mosaics and a welcome notice. The home have a cleaning programme and areas of the home seen on the day of inspection were clean and tidy. Residents said they were satisfied with the standards of cleanliness. Holmlea Care Home DS0000035767.V337445.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A trained and competent workforce are in place which generally meet the dependency needs of residents currently accommodated within the home. EVIDENCE: Relatives and residents report that standards of care are high; ‘they look after us really well’, ‘staff are always happy’, ‘this is a very good care home’. On the day of inspection there were sufficient care staff to meet the needs of residents accommodated within the home. There were four resident vacancies. The manager informed the inspector that all shifts within the home are covered and staff are prepared to do extra shifts e.g. if there is staff sickness. However, as at a previous inspection, staff say they are very busy. The home is organised into four ‘wings’, and there are short term care residents as well as permanent residents on one wing. There are usually four care staff on duty for up to 40 residents (plus day care residents), although sometimes a member of staff may have to accompany a resident to a hospital appointment and on weekend afternoons there are currently only three care Holmlea Care Home DS0000035767.V337445.R01.S.doc Version 5.2 Page 19 staff on duty. In addition to caring for residents, care staff have some domestic responsibilities, e.g. making beds and laundry. The provision of short term care beds means that staff regularly need to make extra time to read care plans to ensure that they have all the information necessary to meet short term care residents’ needs in a satisfactory manner. There is no formal monitoring of resident dependencies; the manager said that on the day of inspection there were only two residents who would be ‘high needs’ (one resident needed two members of staff to transfer). The manager said that funding for more staff time is available to meet the needs of individual residents when necessary. As mentioned previously, staff said that they were very busy in providing day to day care, and this meant that they had little time to spend ‘one to one’ with residents. The importance of ‘one to one’ time has been recognised by staff and managers and should be covered by the ‘key worker’ system. Discussion with the service manager and manager of the home indicated that staffing responsibilities and rotas will be looked at in the near future to ensure that the current staff resources are being used most effectively. There has not been a staff meeting for some time, although one is planned within the next few weeks. This should provide a forum for discussion on how workloads can be organised effectively and enable staff to fulfil their key worker role. There is a stable staff group and staff spoken to were responsible, competent and committed to the welfare of residents. Staff said that ‘we work well together as a team’. Generally speaking they enjoyed their work, and were proud of the standards of care given; ‘this is a lovely home’, ‘the residents are very happy’, ‘I get a lot of satisfaction from working in care’, ‘we get good training and regular supervision’. Two vacancies have been filled recently for one care staff and one domestic. These staff will start after satisfactory CRB checks have been received. The inspector was informed that all mandatory training was up to date. Further staff training is planned, including dementia care and bereavement. Individual staff training records are kept on staff files, but the home also plan to introduced a computerised matrix system so that ongoing training for the whole staff group can be monitored. Three staff files were seen and found to have evidence of CRB checks having been undertaken. The inspector was informed that Derbyshire County Council are now keeping records centrally and not at the home, and these are available for inspection. Holmlea Care Home DS0000035767.V337445.R01.S.doc Version 5.2 Page 20 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. 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. The manager is suitably qualified and experienced and staff demonstrate an awareness of their roles and responsibilities, thus ensuring the home is run in the best interests of residents. EVIDENCE: The manager has the required qualifications and experience to fulfil the responsibilities of her role. There is a management team and individual Holmlea Care Home DS0000035767.V337445.R01.S.doc Version 5.2 Page 21 deputies take responsibility for various aspects of the day to day running of the home and for staff supervision. There was a period from July 2006 to January 2007 when formal Regulation 26 reports were not done as there was no service manager in post. However, interim management support was provided during this time. A service manager is now in post and is providing regular advice and support to the management team. Copies of Regulation 26 visits made since January 2007 were made available and indicated that matters relating to the day to day running of the home are dealt with in a responsible and timely manner. Meetings have been set up with other local Derbyshire County Council home managers to share ideas and plan for continuous improvement. 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, including activities, 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. The information provided by the manager at 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. Holmlea Care Home DS0000035767.V337445.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 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 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X X 3 X 3 STAFFING Standard No Score 27 2 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 X X 3 Holmlea Care Home DS0000035767.V337445.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. 1 Standard OP7 Regulation 15 Requirement The home must continue developing care planning documentation and risk assessments to ensure that staff are fully informed on how to meet residents needs. Timescale for action 30/10/07 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 OP7 Good Practice Recommendations Assessments for residents using ‘wanderguard’ should be undertaken in sufficient detail to ensure that a full explanation is given of the risks and benefits to the resident. Staffing levels should be reviewed so that the key worker role can be fulfilled and ‘one to one’ time spent with residents, which will benefit their quality of life. There should be formal recording of resident dependency levels monitored to ensure staffing levels meet residents’ assessed needs. A staff training matrix should be developed to enable staff DS0000035767.V337445.R01.S.doc Version 5.2 Page 24 2 3 4 OP27 OP27 OP30 Holmlea Care Home 5 OP30 training needs to be monitored. Staff training in dementia should be held to assist in providing care for residents. Holmlea Care Home DS0000035767.V337445.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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.V337445.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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