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Inspection on 06/02/07 for Holmside

Also see our care home review for Holmside for more information

This inspection was carried out on 6th February 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

Residents are involved in daily decision making about their own needs and the running of the home. The home is well maintained and decorated.There is a good level of staff training to give staff more understanding about the different needs of residents. The home offers prospective residents whatever length of time they need to decide if they wish to live at the home. There is a selection of social activities and outings available if residents wish to become involved. There is very good standard of record keeping. Detailed information is given to prospective residents about the services provided by the home. Detailed information is also collected about a new resident to ensure staff can provide the necessary levels of care and support to the person.

What has improved since the last inspection?

There is a programme of decoration and refurbishment around the home. Windows have been double-glazed. The boiler has been replaced. Carpets have been replaced in some bedrooms. Hallways have been decorated.

What the care home could do better:

Care plans must be broken down to include the care and support that is given by staff to meet the needs of residents whose behaviour may be challenging. The practice of storing soiled linen in the bathroom must be revised in the interests of health and safety.

CARE HOMES FOR OLDER PEOPLE Holmside Station Road Bedlington Northumberland NE22 5PP Lead Inspector Karena M Reed Unannounced Inspection 6th February 2007 14:00 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 Holmside DS0000000628.V322894.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. Holmside DS0000000628.V322894.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Holmside Address Station Road Bedlington Northumberland NE22 5PP 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) 01670 530100 01670 530100 Mr M Chawla Mr K K Kholi Mrs Carol Woodhouse Care Home 30 Category(ies) of Dementia - over 65 years of age (7), Old age, registration, with number not falling within any other category (23) of places Holmside DS0000000628.V322894.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th January 2006 Brief Description of the Service: Holmside is a care home registered to provide personal care to thirty residents. Categories of registration include twenty-three places for older people over the age of sixty- five years and seven places for people with memory loss over sixty-five years of age. The home does not provide nursing care. The home is situated in a residential area in Bedlington and is on a bus route. It is close to local shops, pubs and the town centre. The home consists of a large detached house with a garden. All bedrooms are for single occupancy. Bedrooms are available on the ground floor and first floor of the building, a passenger lift is also available to the first floor. There is a very large lounge and combined dining room. There are some assisted bathrooms and lavatories equipped with specialist equipment for the use of residents. A Statement of Purpose and service user guide are available at the home for residents who are interested in coming to live at the home. The guides describe the services and facilities provided by the home and how staff are trained to meet service users’ care and support needs. CSCI Inspection reports are also available at the home detailing the quality of care provided by the home. Fees payable for living at the home at the time of inspection in February vary between £389 .45 and £409. Additional charges are payable for hairdressing, private chiropody, personal toiletries and newspapers. Holmside DS0000000628.V322894.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit was unannounced and took place over two and a half hours. A partial tour of the premises took place and a sample of records were inspected which included: the Home’s Statement of Purpose and service user guide, the home’s maintenance contracts, 5 care plans, 2 personal allowance records, the fire log, accident book, admission /discharge book, complaints record, staff communication book, staff meeting minutes and four staff files. The manager, three carers, cook, ten residents and two relatives were interviewed at the time of inspection. A questionnaire was also completed by the home before the inspection to provide information. Questionnaires were also sent to residents and other people involved with the home that may be able to comment about the running of the home. 9 resident questionnaires were returned. Case tracking was carried out where certain service users and staff were spoken to and their records were examined. Residents said that: “Staff are caring.” “It’s a home from home.” “The food is good, plenty to eat.” What the service does well: Residents are involved in daily decision making about their own needs and the running of the home. The home is well maintained and decorated. Holmside DS0000000628.V322894.R01.S.doc Version 5.2 Page 6 There is a good level of staff training to give staff more understanding about the different needs of residents. The home offers prospective residents whatever length of time they need to decide if they wish to live at the home. There is a selection of social activities and outings available if residents wish to become involved. There is very good standard of record keeping. Detailed information is given to prospective residents about the services provided by the home. Detailed information is also collected about a new resident to ensure staff can provide the necessary levels of care and support to the person. What has improved since the last inspection? There is a programme of decoration and refurbishment around the home. Windows have been double-glazed. The boiler has been replaced. Carpets have been replaced in some bedrooms. Hallways have been decorated. Holmside DS0000000628.V322894.R01.S.doc Version 5.2 Page 7 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. Holmside DS0000000628.V322894.R01.S.doc Version 5.2 Page 8 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 Holmside DS0000000628.V322894.R01.S.doc Version 5.2 Page 9 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 1,3,4,5 Interesting and useful information is given to prospective residents about the home. The home collects enough information about the needs of prospective residents before they move in to help ensure staff are aware of the amount of care and support needs of the resident as they settle in. Staff receive a variety of training to give them the knowledge and insight to help understand the needs of residents and to provide the necessary levels of care and support to individual residents. Residents and their relatives are very welcome to visit the home to assess its suitability. Holmside DS0000000628.V322894.R01.S.doc Version 5.2 Page 10 EVIDENCE: The Home’s Statement of Purpose and service user guide were examined and they contained the necessary information as required by the Care Homes Regulations 2001. They provided detailed information in an interesting and friendly way and this could be made available to residents in other than the written word if required. Records for five of the residents showed that when they were admitted to the home an assessment of their care needs had been carried out before their admission. The resident and relevant people who knew them were involved in the initial assessment. This information and the care manager’s assessment of the resident’s care needs were used to ensure all the needs of the resident could be met by staff. The records contained a range of information. Staff receive training so that they know how to meet the specialist needs of the residents. Staff have received the necessary statutory training: Fire Training, Moving & Assisting, Food Hygiene, Safe Handling of Medication, First Aid, Protection of Vulnerable Adults and National Vocational Qualifications. Staff have also received training about; visual impairment, memory loss, diabetes management, falls awareness, stress management, challenging behaviour and Equality and Diversity. Residents have the opportunity to visit the home as often as they need in order to decide if they want to live there. A resident may come for meals, have overnight stays and be introduced to other residents at the home at a pace suitable to the individual. Holmside DS0000000628.V322894.R01.S.doc Version 5.2 Page 11 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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. 7,8,9,10 There are mostly good arrangements in place to ensure that the health and social care needs of residents’ are met. There is a system of reviewing the changing care needs of residents. Residents are well supported by staff and most care plans show the amount of care and support that staff are providing to residents. There are full arrangements in place to ensure residents health care needs are met. Staff receive training before they are able to administer medication to residents. Residents are treated with respect and their right to privacy is upheld. Holmside DS0000000628.V322894.R01.S.doc Version 5.2 Page 12 EVIDENCE: There are detailed assessments in most of the residents’ care plans. Personal support needs are well documented and give clear instructions to staff on how to support people in tasks such as washing, bathing, dressing, remaining mobile in order to help retain some independence. The care plans for residents with challenging behaviour do not give clear instructions to staff about how to support people with these needs that may be challenging to work with. Care plans are amended and reviewed on a monthly basis by the resident’s key workers, (staff who have special responsibility for each resident). Residents and their families or representatives are involved in the process. Moving and handling assessments are in place. Technical aids and equipment is available for residents. Residents care records showed that they have access to external health care services. GPs and Community Nurses were regularly consulted for advice and treatment. Records show district nurses visit the home as required and residents are helped to use chiropody and optical services at least annually or as often as required. Training records showed senior staff members receive training about medication before they are able to administer it to residents. Risk assessments are in place. Care records, conversation with staff and observation showed the privacy and dignity of residents are respected. All of those residents spoken to said that they were treated well by the staff and are well cared for. Holmside DS0000000628.V322894.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 12,13,14,15 A variety of activities and outings are available to residents. Residents maintain contact with family and friends as they wish. Staff help more dependent residents to exercise choice and control over their lives. Residents enjoy a wholesome and varied diet. EVIDENCE: A lively atmosphere was apparent at the time of inspection. Some residents were taking part in arts and crafts, some were watching television, reading, knitting or listening to music in the communal areas. Some residents were spending time in their bedrooms. A programme of activities is in place for Holmside DS0000000628.V322894.R01.S.doc Version 5.2 Page 14 residents this includes: gardening, videos, sing-a-long, manicurist, dominoes, aerobics, quizzes, crafts and hairdressing. Some residents choose to become involved in activities provided by a voluntary organization that also arranges trips out for residents. Musical and theatrical entertainers also visit the home. Various seasonal parties are also arranged, which are well supported by relatives and families. Residents were positive about the activities provided. Monthly trips are arranged to the local pubs, garden centres, theatres, shops and museums. Some residents also have the opportunity to visit the local community with relatives or with staff. Staff ask each resident about their wishes, interests and choices. The cook talks with the residents to collect up to date ideas for making the menus and finding out about the food likes and dislikes of residents. Residents are also asked daily what they wish to eat from the menu selection. At least two hot meals are provided daily and an alternative is available at teatime. Residents were very positive about the food: On the day of inspection, the tea served was homemade broth and bread buns, assorted sandwiches and cake. Holmside DS0000000628.V322894.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 16,18 The complaints procedure is available to remind people coming into the home of their right to complain. Residents are protected from abuse. EVIDENCE: There is a complaints procedure to inform people visiting the home of how they could complain if necessary. Residents have access to a complaints procedure that assists and supports them to bring any matters to the attention of staff outside of the home in case they felt uncomfortable bringing any complaints or concerns to the attention of staff within their home. The home keeps a record of complaints. One complaint has been received by the home since the last inspection and this has been resolved. Residents spoken to said they knew who to approach if they should ever need to complain. Holmside DS0000000628.V322894.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 19, 26 Residents live in a homely, comfortable and safe environment. There is quite a good standard of hygiene around the home. EVIDENCE: There is a programme of redecoration and improvement around the home. Since the last inspection the hallways have been decorated. Some windows have been replaced with double-glazing, the boiler has been replaced and some bedroom carpets have been replaced. Holmside DS0000000628.V322894.R01.S.doc Version 5.2 Page 17 The home is clean, well decorated and very well maintained apart from some soiled linen was left in the bathroom. The home has enough sitting and dining space. Residents can see visitors in private in their own rooms. Holmside DS0000000628.V322894.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 27,28,29,30 Residents’ needs are met by the numbers and skill mix of staff. Systems are in place to ensure residents are in safe hands. There are sound recruitment policy and practices in place to protect residents. Staff are trained to meet the care needs of residents. EVIDENCE: Examination of staff rotas and discussion with the person in charge and members of the staff team showed that the numbers of staff are as follows: 7.30 am- 3.00pm 3.00 pm- 10.00pm 10.00pm- 8. 00 am Holmside 5 staff 4 staff 2 staff DS0000000628.V322894.R01.S.doc Version 5.2 Page 19 These numbers include the manager. There is a senior staff member on each shift. There is a vacancy for one staff member. Other staff members are employed for duties such as food preparation, maintenance and cleaning. Staff stated that they enjoyed working in the home and were observed to be kind, caring and respectful to residents. A stable committed staff team has been created. The necessary checks are being carried out prior to the workers being appointed. Two written references were available on the staff files examined from the most recent employers. An application form had been completed for each staff member. CRB checks are carried out before a person is appointed. There was no record to state when CRBs had been carried out or a way to remind management when they required renewing. Staff receive Skills for Care induction previously TOPSS. Over 60 of the care staff team have now achieved National Vocational Qualifications at level 2 some are also studying or have obtained level 3. Staff and their records showed that they also receive advice and /or training in other areas such as Fire Training, Moving & Assisting, Food Hygiene, Safe Handling of Medication, First Aid, Protection of Vulnerable Adults and National Vocational Qualifications. Staff have also received training about; visual impairment, memory loss, diabetes management, falls awareness, stress management, challenging behaviour and Equality and Diversity. Holmside DS0000000628.V322894.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 31,32,33,35,37,38 Residents’ live in a home that is well run and managed for the benefit of residents. Residents’ financial interests are safe guarded. The standard of record keeping is very good. The health, safety and welfare of residents and staff are promoted and protected. Holmside DS0000000628.V322894.R01.S.doc Version 5.2 Page 21 EVIDENCE: The registered manager has worked at the home for approximately three years as manager. She has completed a National Vocational Qualification at level 4 and has obtained her Registered Manager’s award. Discussion and observation maintain that she puts the needs of the residents first and promotes an ethos amongst staff of involving staff and residents in decision making within the home. Staff meetings take place regularly and residents and relatives meetings also take place two monthly. The standard of record keeping is very high. All records as required by the Care Homes Regulations 2001 were well documented and completed as required. Lockable facilities are available for residents to keep their own money if they wish. If a resident does not wish to keep control of their own money, the home is able to provide the facility to hold a small amount of money on behalf of the resident for everyday living. Individual records show the home has a suitable system for accounting any monies held on behalf of a resident. Documents detailing fire safety, risk assessments in the environment, water temperatures, maintenance contracts for equipment were all up to date. Holmside DS0000000628.V322894.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 3 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 4 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 x x x x x x 2 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 3 3 x 3 x 3 3 Holmside DS0000000628.V322894.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 2 Standard OP7 OP26 Regulation 15(1) 16(2)(k) Requirement Care plans for working with challenging behaviour must be more detailed. Heavily soiled linen must not be stored in the bathroom. Timescale for action 15/03/07 07/03/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Holmside DS0000000628.V322894.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 Holmside DS0000000628.V322894.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. 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