Inspection on 17/08/05 for Holmwood Home

This inspection was carried out on 17th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Holmwood Home 19/09/07

Holmwood Home 28/06/06

Holmwood Home 24/01/06

Holmwood Home 18/01/05

Holmwood Home 07/04/04

Similar services:

Home Farm

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

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

CARE HOME ADULTS 18-65 Holmwood Home 29 Worsten Drive Ewood Blackburn Lancashire. BB2 4EG Lead Inspector Jane Craig Unannounced 17 August 2005 09:00 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 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 Home F57 F07 S57154 Holmwood V240539 170805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Holmwood Home Address 29 Worsten Drive Ewood Blackburn Lancashire BB2 4EG 01254 662827 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Anthony Samara Care Home Only Personal Care (PC) 3 Category(ies) of Learning Disability (LD) 3 registration, with number of places Holmwood Home F57 F07 S57154 Holmwood V240539 170805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18 January 2005 Brief Description of the Service: Holmwood is privately owned by Mr and Mrs Samara, with Mr Samara taking responsibility for the day-to-day management of the home. Holmwood is registered to provide personal care for up to three residents with learning disabilities. Holmwood is a large detached house on a new residential estate of similar properties. The home is located on the outskirts of Blackburn town centre and is close to local shops and other amenities. There is a local bus service near the home. There are four bedrooms, each with en-suite facilities. A separate shower room is situated on the first floor. Communal space comprises a through lounge/dining room and a conservatory. There is a well equipped kitchen. There are gardens to the front and rear of the house with access to the canal towpath at the rear. Holmwood Home F57 F07 S57154 Holmwood V240539 170805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced, which meant that the residents and staff were not told beforehand when the visit was taking place. The inspection took place over half a day. At the time there were 3 residents living in the home. During the course of the inspection the inspector met with two of the residents, who were asked about their views and experiences of living in the home. Some of their comments are included in this report. Discussions were held with the registered persons a member of staff. A tour of the premises took place and a number of documents and records were viewed. Detailed notes were taken, which have been retained as evidence of the inspection findings. What the service does well: What has improved since the last inspection? Staff had helped residents to fill in surveys to find out what they liked and didn’t like about the home. It was evident that the registered manager took the results seriously and had taken steps to address situations if the residents were not satisfied. The manager had made some improvements to the paperwork. Records that showed how residents’ money was handled were clearer. Some new policies had been written but some needed further improvements. Holmwood Home F57 F07 S57154 Holmwood V240539 170805 Stage 4.doc Version 1.40 Page 6 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. Holmwood Home F57 F07 S57154 Holmwood V240539 170805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Holmwood Home F57 F07 S57154 Holmwood V240539 170805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 The admission procedure included a full assessment to ensure that residents’ needs were understood and could be met before they moved into the home EVIDENCE: Residents had copies of care management assessments on their files. There had been no new admissions to the home since the previous inspection. The registered manager discussed how any prospective residents would be assessed to make sure that their needs could be met at the home. They would also be invited to come to the home for visits and short stays to make sure that the house suited them and they got along with other residents. Holmwood Home F57 F07 S57154 Holmwood V240539 170805 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 and 9 Care plans provided staff with information about how to meet residents’ needs but the lack of updates may result in changes not being identified or addressed. Residents were consulted about their daily lives and routines and were assisted to make their own decisions. Residents were supported to take risks. EVIDENCE: Care plans were drawn up following the resident’s annual review. The plans identified needs, goals and directions as to the type and amount of assistance needed. Residents and family members could be as involved as they wished in drawing up plans. One resident said the registered manager talked about his care plan and that “he reads it to me sometimes.” There was a monthly review of resident’s progress towards meeting goals but care plans were not always updated when changes occurred. Strategies for managing difficult behaviour were recorded. Residents were quite independent and made their own decisions about their daily lives. Staff said they put forward suggestions and residents made decisions. One resident said he decided how to spend his money and that he had chosen his new television himself. Another resident talked about making decisions about what do with his spare time and whether to join in with the Holmwood Home F57 F07 S57154 Holmwood V240539 170805 Stage 4.doc Version 1.40 Page 10 group or do his own thing. The registered manager was supporting one resident who wanted to reduce his medication. Following a requirement made at the previous inspection, residents’ financial records clearly showed any monies received or handed over. There was a risk management policy. Detailed risk assessments and management strategies covered activities indoors and in the wider community and were included on residents’ plans. Holmwood Home F57 F07 S57154 Holmwood V240539 170805 Stage 4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 15 and 17 Residents were provided with good opportunities to engage in a wide range of appropriate activities and were supported to use community facilities. Residents were supported to make and maintain appropriate relationships. The meals were of a good standard and residents were offered choice and variety at times that suited them. EVIDENCE: Residents had a weekly plan outlining a wide variety of activities inside and outside the home. Two residents had voluntary employment and had undertaken relevant training courses. There was evidence that staff were trying to find appropriate daytime activities for another resident. All of the residents used community facilities independently and with staff. One resident said “I have enough to do in the week and I go to Church on Sunday, all my friends go.” Another said “we can go out when we want as long as we tell the staff.” Residents were able to have visitors at any time. A friend from one of the clubs visited regularly and stayed for meals. Residents were supported to form Holmwood Home F57 F07 S57154 Holmwood V240539 170805 Stage 4.doc Version 1.40 Page 12 relationships outside the home and one resident said “I go to my girlfriend’s twice a week.” Another resident said he met his friends at the social club every week. Residents got on very well with the residents from Merlwood. They had meals together and often went out as a group. Meals and mealtimes were very flexible to fit in with residents’ daily activities. They chose from a list of options each mealtime. One resident said, “they give us good meals, good food to eat.” Another said, I enjoy my meals every night.” Records of meals evidenced a healthy and balanced diet. Holmwood Home F57 F07 S57154 Holmwood V240539 170805 Stage 4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 20 Residents’ health was monitored and their needs were identified and met. Inadequate medication policies and management practices may place residents at risk of harm. EVIDENCE: The registered manager stated that all residents had an annual healthcare check and a Health Action Plan but these were not available at the time of the inspection. Residents’ ongoing physical healthcare needs were monitored by staff and one plan showed evidence of regular out patient appointments. Following referral to a dietician one resident was receiving a special diet. Plans showed regular appointments to see the dentist, chiropodist and optician. Residents’ mental health care needs were monitored by the staff and GP, with referrals to the mental health care team as appropriate. Residents said that they were well looked after at the home. Residents had signed consent forms for staff to administer their medicines. Previous requirements to update medication policies and improve records of medication entering the home had not been actioned. Medication administration records (MAR) charts were up to date. Handwritten charts were not signed and witnessed. Medication was stored safely but storage temperatures were not checked. Staff were undertaking a medication training course at the time of the inspection. Holmwood Home F57 F07 S57154 Holmwood V240539 170805 Stage 4.doc Version 1.40 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 Residents knew who to go to if they had any complaints and were sure that they would be acted upon. Staff understanding of adult protection issues safeguarded residents but the lack of accurate procedures may result in allegations not being dealt with appropriately. EVIDENCE: There was a clear complaints procedure, which contained the required information. Residents said that they had no complaints but they would be able to talk to the staff if they had. One said, “I would talk to Jackie, she would do something if I told her.” Another said “they would try to do something about it.” Information gained from residents’ surveys indicated that they thought there was always someone to talk to about problems. Staff received annual training in the protection of vulnerable adults. One member of staff talked about how abuse may be identified with residents who were unable to talk about a problem. A previous requirement to update the home’s adult protection policy had not been actioned but the member of staff was aware that allegations could be reported outside the home. Holmwood Home F57 F07 S57154 Holmwood V240539 170805 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 and 30 The standard of the environment was good, providing residents with a safe, comfortable and homely place to live. EVIDENCE: At the time of the inspection the home was clean and tidy. The house was well maintained and there was a good standard of décor throughout. Furnishings were comfortable and homely. The gardens had been improved and there was a large seating area for residents. Bedrooms were personalised to reflect individual tastes. Residents were happy with the home and their rooms. One said, “I like living in this house and I like my bedroom, it’s handy having your own toilet.” Another said, “It’s a posh house” and of his bedroom, “I think it’s a grand room.” The manager and staff had recently completed an infection control course and there was written guidance on general hygiene procedures. Recommendations from a recent environmental health inspection had been actioned. Holmwood Home F57 F07 S57154 Holmwood V240539 170805 Stage 4.doc Version 1.40 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 34 and 35 Recruitment practices were inadequate and did not protect residents. The lack of a formal induction programme meant that new employees may not receive essential training to assist them to meet the needs of the residents. EVIDENCE: There were appropriate recruitment policies but these were not followed. One new member of staff had been appointed since the last inspection. A CRB disclosure had been obtained but was dated after commencement of employment. Other required pre-employment checks had not been carried out and there were no records or information relating to the employee. The registered manager must take steps to address this. There was no formal induction training programme. The new member of staff said he had read some policies and received awareness training in moving and handling, fire safety, protection of vulnerable adults and first aid but there were no records to confirm this. He had commenced medication training. The registered manager and the two other members of staff had updated their awareness training in safe working practice topics and all had completed a first aid course. Two of the three care staff had commenced NVQ training. Holmwood Home F57 F07 S57154 Holmwood V240539 170805 Stage 4.doc Version 1.40 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 39, 40 and 42 Residents benefited from a well managed home. Systems were in place to enable residents to make their views known and the manager had a good understanding of the areas in which the home needs to improve. Health and safety practices safeguarded residents and staff. EVIDENCE: The registered manager had many years experience in owning and managing the home. He expected to complete the NVQ level 4 in care and management by the end of 2005. The registered manager had completed an infection control course since the previous inspection and was undertaking medication training. The home held the investors in people award. Residents had recently completed surveys with the help of a member of staff. The results indicated that they were happy with the home and their lifestyles and this was confirmed by discussions during the inspection. One resident said, “I like living here, everyone is good to me.” Where a resident had indicated that they were not Holmwood Home F57 F07 S57154 Holmwood V240539 170805 Stage 4.doc Version 1.40 Page 18 satisfied about one aspect, the registered manager had discussed it with them and taken steps to address the situation. There were no other mechanisms for auditing the quality of the service. There was no formal development plan but from discussions with the registered manager it was apparent that general improvements were planned. A previous recommendation to develop a full set of relevant policies and procedures had been actioned. However, some existing policies were out of date and should be reviewed. Staff held certificates to evidence updated training in safe working practice topics. Maintenance and servicing of fire equipment, gas appliances and electrical installations were up to date. The registered manager showed a good understanding of his responsibilities with regard to health and safety. Holmwood Home F57 F07 S57154 Holmwood V240539 170805 Stage 4.doc Version 1.40 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x 3 x x Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 2 3 x 3 x 3 Standard No 31 32 33 34 35 36 Score x 2 x 1 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Holmwood Home Score x 2 2 x Standard No 37 38 39 40 41 42 43 Score 2 x 2 2 x 3 x F57 F07 S57154 Holmwood V240539 170805 Stage 4.doc Version 1.40 Page 20 Are there any outstanding requirements from the last inspection? 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 6 20 Regulation 15 13(2) Requirement Care plans must be updated as and when changes occur. Medication policies and procedures must be reviewed in line with relevant guidelines. (Timescale of 31/03/05 not met) Accurate records of medication entering the home must be kept. (Timescale of 01/03/05 not met) Recruitment practices must be improved. Pre-employment checks must be conducted.The required documents and information relating to staff must be obtained and retained on file. Induction training records must be kept. Timescale for action 31/08/05 30/11/05 3. 4. 20 34 13(2) 19 31/08/05 31/08/05 5. 35 19 31/08/05 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 19 20 Good Practice Recommendations Residents Health Action Plans should be kept with their care records. Handwritten amendments to MAR charts should be signed and witnessed. F57 F07 S57154 Holmwood V240539 170805 Stage 4.doc Version 1.40 Page 21 Holmwood Home 3. 4. 5. 6. 7. 8. 9. 20 23 32 35 37 39 40 The temperatures of medication storage areas should be recorded on a regular basis. The protection of vulnerable adults policy should be amended to include accurate directions for reporting suspected abuse. 50 of care staff should be trained to NVQ level 2 by December 2005. The induction training programme should meet the national training organisation specifications. The registered manager should complete the NVQ level 4 in care and management by December 2005. The quality assurance systems should be further developed. Policies and procedures should be kept under review. Holmwood Home F57 F07 S57154 Holmwood V240539 170805 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection 1st Floor, Unit 4 Petre Road, Clayton-Le-Moors Accrington Lancashire. BB5 5JB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Holmwood Home F57 F07 S57154 Holmwood V240539 170805 Stage 4.doc Version 1.40 Page 23 - 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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