Inspection on 27/07/06 for Holmwood

This inspection was carried out on 27th July 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Holmwood 05/08/08

Holmwood 10/08/07

Holmwood 21/12/06

Holmwood 11/03/06

Holmwood 04/08/05

Holmwood 21/03/05

Holmwood 10/06/04

Holmwood 17/02/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Holmwood 39 Chine Walk West Parley Ferndown Dorset BH22 8PR Lead Inspector Tracey Cockburn Unannounced Inspection 11:15 27 July & 7 August 2006 th th 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 Holmwood DS0000026820.V303498.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. Holmwood DS0000026820.V303498.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Holmwood Address 39 Chine Walk West Parley Ferndown Dorset BH22 8PR 01202 593662 NO FAX 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) Mrs Margaret Anne Gallagher Care Home 13 Category(ies) of Old age, not falling within any other category registration, with number (13) of places Holmwood DS0000026820.V303498.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2 double rooms Date of last inspection 11th March 2006 Brief Description of the Service: Holmwood Care Home is owned and managed by Mrs Gallagher, it is registered to accommodate a maximum of 13 elderly residents in nine single and two double rooms. The home normally operates with all rooms occupied singly. Nine of the bedrooms, all with en-suite baths or showers, are situated on the ground floor; the remaining two rooms are located on the first floor. The communal lounges and dining room are on the ground floor. There is no passenger lift or stair lift so those service users accommodated on the first floor need to be mobile enough to manage the stairs. The home usually accommodates the more independent type of resident, although full time care is provided. The back garden has established shrubs, hedges and trees providing a sheltered environment. Garden seating is available. Residents do not use the front garden areas but have mature trees and shrubs, which surround the home; a gravelled car parking area is available for visitors and staff to use. The home is situated in a quiet road a short drive away from the centre of Ferndown, which has a good selection of shops and local amenities. Holmwood DS0000026820.V303498.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection, which took place over two separate days. The inspection began on 27th July 2006 and was completed on 7th August 2006. On the 27th July care records were examined, staff spoken to and a tour of the premises and garden took place. Residents were also spoken to both in the lounge and in their own rooms. The registered provider was on holiday on that day hence the return a week later. Mrs Gallagher will be forwarding records to the inspector to confirm that actions have been taken. A total of 6 hours was spent inspecting the home. Preparation for this visit also included checking comment cards, reviewing Regulation 37 notices and comments from relatives. What the service does well: What has improved since the last inspection? What they could do better: At the conclusion of this inspection there are 12 requirements and 3 recommendations. If there is no improvement at the next inspection enforcement action will be taken. The statement of purpose and service user guide have to reflect accurately the home so that people who may be considering moving into the home have the information they need to make an informed choice. Individual care plans need to contain more information to ensure that residents health, social and personal care needs are met. The home must consider varying the meals being prepared week in week out. Complaints have to be listened to, taken seriously and acted upon as well as clearly recorded. Staff must receive the training they need to protect residents from abuse. The home must be better maintained. The registered provider has to ensure that requirements are met. The home must be able to demonstrate it is run in the best interests of residents. Resident’s safety must be considered at all times. Holmwood DS0000026820.V303498.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Holmwood DS0000026820.V303498.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 Holmwood DS0000026820.V303498.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): 1&3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People thinking of moving into the home should have the information they need to make an informed decision. People who move into the home have their needs assessed however there should be greater detail so that the provider is able to give assurance that the home can meet their needs fully. EVIDENCE: The home has a statement of purpose and service user guide however there is not one readily available in the home for visitors to view. The recommendation from previous inspections has not been met and is therefore repeated. Since the inspection Mrs Gallagher has informed the commission that an up to date copy of the homes statement of purpose and service user guide is kept in the kitchen should people wish to view it. The home has had no new residents since the last inspection. There is evidence of assessments being completed and evidence of LA assessments in files. 4 files were looked at and all contained an assessment and care plan. Holmwood DS0000026820.V303498.R01.S.doc Version 5.2 Page 9 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. Resident’s have individual plans of care which set out their health, personal and social care needs, however some areas lack the detail needed to ensure that care staff know what action to take. Resident’s health needs are responded to appropriately. The home has a medication policy and procedure, which ensures the safety of residents. On the whole residents are treated with dignity and respect and their privacy respected. EVIDENCE: Mrs Gallagher has recently updated her care plans and these are now a tick box with a box for additional information. Throughout the care files seen there was evidence that the advice of health care professionals was sought, during the inspection a district nurse was visiting several residents, they were seen individually in their own rooms. Holmwood DS0000026820.V303498.R01.S.doc Version 5.2 Page 10 The home operates a monitored dosage system for dispensing medicines, Boots oversees this. Mrs Gallagher says that staff have training from Boots in the safe handling of medication, however no paper evidence was seen. All the medication is stored in a cupboard in the kitchen; the lock on the cupboard door is not secure enough and should be upgraded. Residents spoken to say that they are treated with respect, one or two residents said that sometimes they thought that staff were not as polite as they could be. Holmwood DS0000026820.V303498.R01.S.doc Version 5.2 Page 11 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 adequate. This judgement has been made using available evidence including a visit to this service. Resident’s find their experiences of living in the home on the whole matches their expectations. Residents are able to maintain contact with the people they want to and are supported to have choice and control of their lives. The menu is varied but repetitive. EVIDENCE: Residents say there is not much entertainment in the home; sometimes they have someone who comes to sing. There is also someone who comes to do exercises and follows this with a quiz once a fortnight. Records seen for residents show that their hobbies and interests are recorded but this is not always consistent. Mrs Gallagher explained that since she has transferred over to a new system of recording she did not transfer over all the information. Since the inspection Mrs Gallagher has written to the commission detailing the other activities which take place in the home including playing bingo every week, board games, jigsaws and card games being available to residents when they want them. Mrs Gallagher has also checked her records and although Holmwood DS0000026820.V303498.R01.S.doc Version 5.2 Page 12 hobbies and interests had not been transferred onto the new documentation of one resident the information was available in another part of the file. Residents say the staff treat them with dignity and respect. At the time of the inspection residents were having lunch of roast chicken and fresh vegetables. A member of care staff prepared this. The food looked appetising and plentiful. There is no weekly menu as such but each meal is recorded in a daily log. It was noted that the meals are very repetitive for example most Saturdays turkey burgers are the main meal at lunchtime and on some occasions the main meal on a Sunday is roast turkey. The lack of variety was discussed with Mrs Gallagher who said that residents like the traditional meals of roast etc. However some of the residents said that they did not always want the same food each week. The menu at teatime is also recorded for each person in the daily log, and this also reads as very repetitive with residents mostly eating sandwiches for tea. The staff say that there is a variety of different food available such as soup, quiche and different things on toast such as eggs. Mrs Gallagher says that residents are able to have whatever they want at teatime, the record in the diary shows that residents seem to choose sandwiches. One resident said that she has never been offered anything other than sandwiches. Several residents said that they are only ever offered sandwiches as an option and would like to be given more choice. The freezer was well stocked with a variety of frozen meats and vegetables. Hot drinks are available during the day and residents said that they had plenty to drink during the hot spell. Meals are eaten in a small dining room leading from the lounge; there is a patio door. Most residents spoken to say that they always try and come to the dining room for their main meal each day. The meal seen on the day of the inspection was not hurried. There was evidence of fresh fruit and vegetables and the larder was well stocked with tins of soup, fish, fruit, and pulses. Since the inspection Mrs Gallagher has written to the commission concerned that the report did not accurately reflect the choices available. Mrs Gallagher has reiterated her comments at the time of the inspection that residents can have whatever they wish at mealtimes. Mrs Gallagher provided an extensive list of choices available to residents which they are able to have at high tea. Holmwood DS0000026820.V303498.R01.S.doc Version 5.2 Page 13 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 poor. This judgement has been made using available evidence including a visit to this service. The home has a complaints policy and procedure, residents feel listened to. The home has a procedure in place for adult protection however al lack of training means residents are not fully protected. EVIDENCE: The home has a complaints policy and procedure. There have been some issues recorded within the home but not dealt with under the homes own policy. The requirement made at the last inspection regarding training for staff in adult protection has been repeated for the second time. If there is not action taken to find appropriate training for staff enforcement action will be considered. Staff said that they had not received any training in this area. Mrs Gallagher has informed the commission that she has bought in a policy and is able to train staff on this subject. Holmwood DS0000026820.V303498.R01.S.doc Version 5.2 Page 14 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 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents live in an environment, which requires improvement both inside and outside. The home is clean but cluttered. Some areas of the home are pleasant. EVIDENCE: There is evidence at this inspection that the routine maintenance of the home is not taking place both inside and outside the home. The entrance to the home is overgrown with ivy encroaching in the path leading to the front door. There are decorating items such as used paint pots lying around outside close to doors. There is an old oven sitting on the patio, there are other broken items around the patio area of the home. Inside the home the carpet is in a very poor state, badly stained in many areas such as corridors, in the lounge and in some residents bedrooms. The owner explained that due to a slow leak from the boiler some of the carpet has been Holmwood DS0000026820.V303498.R01.S.doc Version 5.2 Page 15 damaged. The owner also explained that a carpet fitter has been to measure the whole home and all carpets in communal areas will be replaced with the next few weeks. One resident when asked about the state of the carpet said: “It was terrible and that the colour, beige, didn’t help.” The home also has clutter in the small lounge area leading from the main lounge; a door, mirror and pieces of wood are propped against a wall by the large table used to build jigsaws. There are also 3 ceiling lights being stored haphazardly in this area. It was also noted that there are too many chairs. There was also crockery on the floor and 2 blue bags, used to return the monitored dosage system used packets to the pharmacy. This situation remains unchanged from the inspection in March. The laundry room is still not clearly marked. It is not a room it is located in a cupboard at the end of a corridor, at the time of the inspection the machine was not in use but the door was unlocked and the sign on the door refers to the fridge, which is in fact somewhere else. Holmwood DS0000026820.V303498.R01.S.doc Version 5.2 Page 16 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 adequate. This judgement has been made using available evidence including a visit to this service. Staff on duty understand the care needs of the residents. Lack of training in some areas means that residents potentially are not in safe hands at all times. The homes recruitment policy has been improved. Staff are competent but require further training in some areas to ensure the safety of residents. EVIDENCE: At the time of the inspection there were 2 members of staff on duty, one was cooking lunch and the other was seeing to the care needs of the residents. The home has a core group of staff that have worked in the home a number of years, all staff are part time. One of the members of staff on duty had worked in the home for 10 years and was leaving that day. If there are only 2 staff on duty and one is preparing the mid day meal this can detract from the care being provided. Holmwood DS0000026820.V303498.R01.S.doc Version 5.2 Page 17 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 adequate. This judgement has been made using available evidence including a visit to this service. The manager is fit to be in charge but must meet outstanding requirements to fully demonstrate their fitness to operate a care home. The home has a quality assurance system which is working towards demonstrating the needs of residents are met. The home does not manage the finances of any resident. The home must do more to ensure the health; safety and welfare of residents are protected. Holmwood DS0000026820.V303498.R01.S.doc Version 5.2 Page 18 EVIDENCE: The owner Mrs Gallagher has the experience necessary to run a care home. However over the past 2 inspections there has been no movement to improve by ensuring the outstanding requirements have been met. Mrs Gallagher has been made aware of the enforcement policy of the commission and has said that she will ensure that the outstanding requirements are met. Mrs Gallagher has written to the commission advising them of her quality assurance system which will be looked at in detail at the next inspection. The home does not manage the finances of any resident. The home ensures that staff are placed on training courses to regularly update their work. Evidence was not seen on the day of the inspection but Mrs Gallagher agreed to forward this information to the commission. However as stated earlier under outcome heading “protection” staff have not yet received training in adult protection. The central heating has recently been serviced; a certificate was not seen at the time of the inspection. There is no window restrictor on the occupied bedroom on the first floor. The pathways and garden need to be maintained to a good standard, at the time of the inspection this was not the case and there was a number of items lying around which could pose a hazard to any residents who were walking around the garden and patio. Mrs Gallagher has advised the commission that staff are receiving induction and foundation training to meet skills for Care specifications. Holmwood DS0000026820.V303498.R01.S.doc Version 5.2 Page 19 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 2 x 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 2 1 x x x x 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 2 x 2 x 3 x x 2 Holmwood DS0000026820.V303498.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement The registered provider must ensure that the Statement of Purpose contains all the matters listed in schedule 1. Care Plans must be clear on how the health and welfare needs of each individual resident are to be met. The medicine must be stored in a place that is securely locked. The registered provider must provide a written menu for residents. The registered provider must ensure that any complaint is fully investigated. The registered provider must make every effort to ensure that all staff receive training in adult protection policy and procedures The registered provider must either clean adequately or replace the worn, damaged and stained communal carpets throughout the home and in some residents bedrooms The registered provider must make sure the external grounds are suitable and safe for the use of residents. DS0000026820.V303498.R01.S.doc Timescale for action 31/10/06 1 OP1 4(1) (c) 2 3 4 5 OP7 OP9 OP15 OP16 15 (1) 13(2) 16(2)(i) 22(3) 31/10/06 30/09/06 31/10/06 31/10/06 6 OP18 13(6) 30/11/06 7 OP19 16(2)(c) 31/10/06 8 OP19 23(2)(o) 30/11/06 Holmwood Version 5.2 Page 21 9 OP31 10(1) 10 OP38 13(4) The registered provider must discharge their responsibilities fully by complying with the requirements in agreed timescales. There must be window restrictors on the first floor windows. 31/10/06 31/10/06 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 OP3 OP8 Good Practice Recommendations Assessments should demonstrate that the resident was involved in the process. An accident record book that complies with Data Protection should be obtained and used in the home. Holmwood DS0000026820.V303498.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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