Inspection on 28/06/06 for Holmwood Home

This inspection was carried out on 28th June 2006.

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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Holmwood Home 19/09/07

Holmwood Home 24/01/06

Holmwood Home 17/08/05

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 Mr Graham Oldham Unannounced Inspection 20th September 2006 10:00 Holmwood Home DS0000057154.V289622.R01.S.doc Version 5.1 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 Home DS0000057154.V289622.R01.S.doc Version 5.1 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 Adults 18-65. 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 Home DS0000057154.V289622.R01.S.doc Version 5.1 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 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) Mr Anthony Samara Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Holmwood Home DS0000057154.V289622.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th January 2006 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 nearby. 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. A statement of purpose and service users guide is available for residents or their families to be informed of the facilities and services the home provides. The fees for Merlwood range from £312 to £450 per week. Not included within the fees are hairdressing, newspapers or periodicals and outings. Holmwood Home DS0000057154.V289622.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took place on the 20th September 2006. Much of the information gained was obtained from talking to the responsible person and a member of staff (Mr Samara). Residents were observed for cleanliness, their general demeanour and were able to answer simple questions. Two residents were case tracked. Case tracking gave the inspector an overall view of the specific care for the individual resident by checking the plans of care, other documentation and talking to the proprietors. The inspector took detailed notes during the inspection, which have been retained as evidence. The responsible person had undertaken work to meet requirements and recommendations made at the last inspection. Some of the work undertaken had been excessive or misunderstood. Paperwork examined included plans of care, assessment documentation, policies and procedures or documents relevant to each standard. A tour of the building was conducted. What the service does well: The statement of purpose and service user guide had been issued to each resident to ensure they or their families were aware of the facilities and services the home provided. Each resident had been issued with a contract/ terms and conditions document to ensure the terms and conditions of residence were understood. Residents were able to make decisions to enable them to lead a more independent life. Residents were allowed to take calculated risks to lead a more fulfilling life. Residents attended leisure and work activities to provide stimulation. Residents were able to access the community and meet family and friends to maintain contact with whom they wished. Resident’s personal care was given privately to help maintain their dignity. The good standard of the homes environment enabled residents to lead a comfortable life. Staff were aware of the risk to vulnerable adults and residents were able to complain if they wished to help protect them from possible harm. Staff were well trained in aspects of health and safety to protect the welfare of residents. Holmwood Home DS0000057154.V289622.R01.S.doc Version 5.1 Page 6 Sufficient numbers of well trained staff were employed to care for the needs of residents. 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. Holmwood Home DS0000057154.V289622.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Holmwood Home DS0000057154.V289622.R01.S.doc Version 5.1 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 the following standard(s): 1,2,3,4 and 5 The statement of purpose and service user guide informed prospective residents of the facilities and services the home provided. Prospective residents were assessed and offered trial visits to make an informed choice to enter the home. Resident’s specific health care needs were met. Residents were issued with the terms and conditions of residency to ensure they knew their rights. EVIDENCE: Two residents were case tracked during the inspection. Contained within a separate box file for each resident was a copy of the statement of purpose and service user guide. The statement of purpose and service user guide informed residents and interested professionals of the services and facilities that were provided at the home. Two residents case tracked files contained evidence a good assessment had been carried out prior to admission. No new residents had been admitted since the last key inspection. There was a copy of social services assessment for each resident. The assessment of residents ensured staff were able to develop a plan of care and meet the needs of prospective residents. A member of staff said, “People can access the internet to find out about our service. We ask if they want a look around. If they like the home we would look at their needs. We would then try a trial visit for a day and increase the frequency such as an overnight stay. If everything is all right we offer them a place”. Prospective residents were offered a chance to ‘test drive’ the home prior to admission. Holmwood Home DS0000057154.V289622.R01.S.doc Version 5.1 Page 9 Two files were examined during the case tracking process. Evidence was obtained of resident’s visits to professionals such as chiropodists, learning disability specialists and mental health specialists. Staff were observed communicating with residents and helped in the inspection process. One resident had access to his preferred religious group. The health and spiritual needs of residents were met at the home. During the case tracking process a contract/terms and conditions document was observed within the case note files. Residents had signed the document. Residents were aware of their rights (to the best of their abilities). Holmwood Home DS0000057154.V289622.R01.S.doc Version 5.1 Page 10 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 the following standard(s): 6,7 and 9 Each resident had a plan of care, which was up to date and reflected the care each individual required. Residents were able to make decisions to maximise their independence. Residents undertook risks to help maximise their choices. EVIDENCE: Two plans of care were examined during case tracking. Both plans of care were detailed and contained up to date information following regular review. Residents were aware of their care plans but had limited knowledge of what they contained. Both residents case tracked were happy with their care and said, “I like it here and would not like to move” and “they look after me well”. Plans of care informed staff of the needs of residents. Risk assessments, personal to each resident, were observed during the case tracking process. Risk assessments were for the protection of residents. Residents said they retained choices within the routine of the home. During case tracking residents said they chose when to go to bed and get up, went out independently and attended various day centres and clubs if they wished. One resident said, “I keep my own money and get paid on a Wednesday”. A member of staff said, “residents look after their own finances if they can manage to do so”. Residents were able to make decisions to maximise their independence. Holmwood Home DS0000057154.V289622.R01.S.doc Version 5.1 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 the following standard(s): 12, 13, 15, 16 and 17 Residents were able to access the community and take part in suitable activities to maximise their fulfilment. Residents were able to remain in contact with their families and friends to remain socially active. Residents were treated as individuals to protect their rights. Meals were satisfactory and met residents nutritional needs. EVIDENCE: The person in charge said, “1 resident is taking a computer course at college. 1 resident goes to a community centre. 1 resident works in a café and another resident works at McDonalds”. One resident who was case tracked went out shopping twice during the inspection. Activities discussed with residents case tracked included, “bingo, shopping, gardening, going to the gym, going to day centres or clubs, watching television, playing music and doing arts and crafts”. Residents told the inspector they had been on holiday to Pontins and had enjoyed it. Other activities included going to a disco or karaoke evening, day trips to places such as Blackpool and going out for meals. Leisure activities were provided to help resident’s enjoy their lives. Resident’s case tracked said, “I see my mum on a Wednesday and go home sometimes” and “I have a girlfriend”. The person in charge said, “We arrange Holmwood Home DS0000057154.V289622.R01.S.doc Version 5.1 Page 12 contact if residents need our help”. Family and friend contact met resident’s expectations. The person in charge said, “residents are able to vote. We usually offer a postal vote but will take residents to a polling booth if they want”. Residents had access to a church of their faith. One resident went more than once a week. Residents worked in the community and had access to local transport. Residents were encouraged to work. Residents were taught life skills such as cooking and gardening. Resident’s rights were protected. Residents were observed being able to join in or remain in their rooms as they wished. Staff interacted well with residents during the inspection. Access was allowed to all parts of the home unless a risk assessment demonstrated this was not possible. The daily routines of the home were flexible and promoted independence and protected residents dignity. Resident’s case tracked described food as “very good. I help shop and pick the food” and “we get good meals”. Environmental health checks had been completed and there was a rota to keep the kitchens clean. The dining area was sufficient for the residents accommodated at the home. There was a cooked option at least twice a day. Resident’s weights were recorded if necessary. Residents went out for a meal on a regular basis. No residents needed a different cultural or religious diet. Food served at the home was enjoyed by residents and met their nutritional needs. Holmwood Home DS0000057154.V289622.R01.S.doc Version 5.1 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 the following standard(s): 18, 19 and 20 Residents were able to make informed choices and retain some independent living. Residents physical and emotional health needs were met. Medication policies and procedures were good and protected the welfare of residents. EVIDENCE: Resident’s case tracked said they were allowed choices within the routine of the home. Residents said, “I choose what time I get up and go to bed. I choose what I want to eat” and “I go to the shops when I want and can go out when I want”. The person in charge said, “residents can look after their personal care. We just check that everything is all right” and “they choose their own bedtimes and we would only intervene if this was excessive”. Resident’s case tracked said they “bought their own clothes” or “my mother buys my clothes”. Residents were able to choose what they did to maximise their contentment. Two residents files examined during the case tracking process contained evidence residents had access to health care specialists. There was a chart showing staff when residents had appointments. Resident’s health action plans were retained within their plans of care. The health care needs of residents were regularly reviewed and staff had an overview of each residents needs. The medication policy had been amended to enable staff to administer medication safely. Drugs were stored securely. Staff needed to attend accredited training for the administration of medication. Two members of staff Holmwood Home DS0000057154.V289622.R01.S.doc Version 5.1 Page 14 signed the drug administration chart where necessary. No controlled drugs were being administered at the home at the time of the inspection. Residents had agreed they could not self-administer. Medication entering the home was now recorded. Policies and procedures for the administration of medication was safe although staff need to attend training to fully protect the health and welfare of residents. Holmwood Home DS0000057154.V289622.R01.S.doc Version 5.1 Page 15 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 the following standard(s): 22 and 23 Residents were able to voice their concerns if they wished. Policies and procedures for the protection of vulnerable adults helped safeguard residents from possible abuse. EVIDENCE: Residents were able to talk to staff formally and informally to voice their opinions. No complaints had been made about the service to the CSCI since the last inspection. There was a satisfactory complaints procedure. One resident case tracked said he could complain at the day centre. Residents were able to access help if they needed to complain. The home had updated policies and procedures for the protection of vulnerable adults. The home had a whistle blowing policy and a copy of the ‘No Secrets’ Document. The home used the Blackburn with Darwen Adult Abuse procedures to follow a local initiative. Staff had attended training for the protection of vulnerable adults. Policies, procedures and staff training protected residents from possible abuse. Holmwood Home DS0000057154.V289622.R01.S.doc Version 5.1 Page 16 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 the following standard(s): 24 - 30 The environment met the needs of the residents accommodated at the home. EVIDENCE: A tour of the building was conducted on the day of the inspection. The home was warm, clean and tidy. Furnishings were comfortable and suitable in style for the resident group accommodated. Furnishings and fittings were domestic in character and of a good standard. Each resident had their own room, which had been personalised to their tastes. Rooms contained a good amount of furnishings and equipment. Local facilities could be assessed by public transport. The home had transport for group or individual outings. Toilets and bathrooms were suitable for residents needs. There was sufficient communal space. Laundry facilities were suitable and did not impinge on kitchen or food preparation areas. One resident case tracked said, “I am happy with my room”. The other resident case tracked showed the inspector his room and all his leisure equipment. There was good access to outdoor space. The homely environment provided good living accommodation for the resident group accommodated at the home. Holmwood Home DS0000057154.V289622.R01.S.doc Version 5.1 Page 17 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Residents were supported by sufficient numbers of well-trained staff. Recruitment policies and procedures protected residents from possible abuse. EVIDENCE: Two staff files were examined during the inspection. Examination of the files demonstrated the owners had responded to CSCI instruction to ensure all the information required for recruitment was obtained. No new staff had been employed since the last key inspection. The person in charge said, “I am aware of what we need to do if we employ anyone else”. Recruitment procedures protected residents from staff who may not be suitable to work with vulnerable adults. 80 of staff had completed NVQ2 qualifications in care. Staff had undertaken further training in topics suitable for the resident group accommodated at the home. There was a training profile for each individual and the home as a whole. It was recommended that a member of staff take a qualification within the learning disability area. There were sufficient numbers of staff on duty on the day of the inspection to meet the needs of residents. The off duty roster demonstrated this was the norm. Resident’s needs were met by a well-trained staff team. Holmwood Home DS0000057154.V289622.R01.S.doc Version 5.1 Page 18 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 The registered person was suitably qualified and experienced to manage the home for the benefit of residents and staff. The registered person needs to undertake quality assurance work to gain the views of residents and their families. Policies and procedures had been reviewed to ensure practice was up to date. The health and welfare of residents and staff was protected. EVIDENCE: The person in charge said, “We completed our registered managers awards in May. We are waiting for our certificates”. Both the registered provider and her husband had many years experience working with this resident group. The management team at the home had sufficient experience and qualifications to look after the residents accommodated at the home. The person in charge had misunderstood what was required for quality assurance systems to meet CSCI standards. There were recorded staff and residents meetings. A lot of work had been undertaken for a quality management system, which demonstrated the person in charge had the desire to meet the standard but had approached quality assurance from the wrong angle. Advice was given on what was required. The views of residents, families Holmwood Home DS0000057154.V289622.R01.S.doc Version 5.1 Page 19 and stakeholders must be gained and a summary produced to ensure the views of all are taken and acted upon. Fire alarm systems had been maintained and fire drills and equipment tests had been carried out. Gas and electrical appliances had been maintained. The person in charge was aware of health and safety legislation. There was a health and safety policy and procedures. Accidents were recorded. Safety procedures were available for staff to read. Staff had been trained in aspects of health and safety such as fire awareness, moving and handling, first aid, health and safety, risk assessment, infection control, protection of vulnerable adults and food hygiene. Health and safety policies, procedures and training protected the welfare of staff and residents. Holmwood Home DS0000057154.V289622.R01.S.doc Version 5.1 Page 20 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 Standard No Score 1 3 2 3 3 3 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 2 3 X 3 X Holmwood Home DS0000057154.V289622.R01.S.doc Version 5.1 Page 21 Yes 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. Standard YA20 Regulation 13(2) 18 Requirement All staff responsible for handling medication must receive appropriate training. (Timescale of 30/4/06 not met) The registered person must undertake quality assurance work to gain the views of those concerned with the home Timescale for action 31/12/06 2. YA39 24 31/01/07 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. 2. Refer to Standard YA6 YA20 Good Practice Recommendations The responsible person should look at some known models to help to further develop and simplify plans of care. The responsible person should ensure medication policies and procedures contain simplified instructions for staff to follow. Holmwood Home DS0000057154.V289622.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington 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 DS0000057154.V289622.R01.S.doc Version 5.1 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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