Inspection on 11/10/05 for Holmwood House

This inspection was carried out on 11th October 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 House 16/10/07

Holmwood House 26/02/07

Holmwood House 09/05/05

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Holmwood House Austin Fields King`s Lynn Norfolk PE30 1PH Lead Inspector Mr Christopher Handley Unannounced Inspection 11th October 2005 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Holmwood House DS0000062973.V256231.R02.S.doc Version 5.0 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 House DS0000062973.V256231.R02.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Holmwood House Address Austin Fields King`s Lynn Norfolk PE30 1PH 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) 01553 773529 01553 773529 Integrated Nursing Homes Limited Mrs Pamela Jordan Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places Holmwood House DS0000062973.V256231.R02.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th May 2005 Brief Description of the Service: Holmwood House is a registered care home of modern design. There are 35 beds, all of which are on the ground floor, and 50 of the rooms are en suite. There are small gardens at the front and rear of the home. The home is situated close to the centre of Kings Lynn. Any nursing care required is provided by the District Nursing Service. Medical services are provided by the G.P. services. Holmwood House DS0000062973.V256231.R02.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out as part of the annual inspection programme. Six residents, 5 members of staff and two official visitors to the home were interviewed. A tour of the home was undertaken by the Inspector accompanied by the Manager. A total of 18 standards were inspected. The inspection commenced at 9.30 and finished at 3.30. The Manager, Mrs Pamela Jordon, assisted with the inspection. What the service does well: 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 House DS0000062973.V256231.R02.S.doc Version 5.0 Page 6 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 House DS0000062973.V256231.R02.S.doc Version 5.0 Page 7 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): 1,2,3 Residents are provided with a wide range of information about the home. All residents are provided with a detailed contract/statement of terms and conditions. Pre-admission assessments are carried on all prospective residents. EVIDENCE: Prospective residents are provided with a Statement of Purpose, and Service Users Guide prior to coming into the home. The documents contain all the information required. In the inspection dated 9/5/05 it was recommended that the print size be increased for people who may have poor sight. This has since been done and the Manager is commended for this. Some of the residents interviewed were aware of these documents and knew that they contained information about the home. Staff interviewed considered this information important, they said that residents should know about the home that they were coming to. Holmwood House DS0000062973.V256231.R02.S.doc Version 5.0 Page 8 All residents are provided with a Terms and Condition or Contract, a copy of which was seen. The Manager reads through the document with the residents/relatives to ensure their understanding of the document. It is signed and a copy kept in the office. At the previous inspection it was recommended that the print size be increased to assist residents who may have poor sight. This has since been done and the Manager is commended for this. The staff interviewed were aware that residents had contracts, and that they were important documents to them. A number of the residents had contracts in their rooms and were aware of them. They told the inspector that they had read them. The Manager or Deputy carry out pre-admission assessment so as to ensure that the home can meet the needs pf prospective residents. Personal details, and an assessment of physical health and social welfare is taken. There is a very limited mental health assessment and it is recommended that this be made more comprehensive, as poor mental health is not uncommon in elderly people. Holmwood House DS0000062973.V256231.R02.S.doc Version 5.0 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): 7,9,11. All residents have an individual care plan . The home’s medicine system is now safer than previously. Care and comfort are provided to the dying resident, and their death is handled with dignity and propriety. EVIDENCE: All residents have an individual care plan. The care plans of 3 residents were examined and they contain basic information which is sufficient for care to be provided. A wide range of assessment documentation was also read, including risk Assessment, Moving and Handling, Pressure Sore Assessment, Nutritional Assessment. In the last report dated 9/5/04 it was recommended that a major review of the care planning documents be undertaken by the Manager and Regional Manager. At the time the care plans lacked clarity and structure. Holmwood House DS0000062973.V256231.R02.S.doc Version 5.0 Page 10 This major review is in progress at present and the Inspector looks forward to seeing the completed documentation. It is intended to provide training prior to the new system being implemented. Daily records were also read. Three of the new sets of care plans have been completed and they look as though they will be much more effective documents. The medicine system was inspected. The home uses a monitored dosage system, which they believe works well. The administration of medicine is neatly initialled. All staff that administer medicines have received certificated training from Boots. The home has a written procedure for managing medicines. The home has a Controlled Drug cupboard and one controlled medicine was counted and found to be correct. In the last inspection a requirement that the controlled cupboard should be kept locked when not in use was made. At this inspection the cupboard was found to be locked. The medicine trolley is kept locked and is locked to the wall. Its contents were orderly and no loose or unaccounted for medication was seen. The home enjoys a good working relationship with the supplying pharmacist. If staff had any concerns about the effects of medicines on residents they would contact the prescribing doctor. At present the Controlled Drug cupboard is nearly full and it is likely that this situation will continue. The Inspector recommends that the home obtain a larger Controlled Drug cupboard, to prevent overcrowding and mistakes. Care and comfort is provided to residents at all times but especially at the time of death. Dying is handled with dignity and families are strongly supported, they can visit at any time. The dying wishes of residents are recorded in the residents notes. Refreshments are provided for relatives, they can stay overnight if they wish. Representatives of religious organisation attend when requested. The Inspector saw the home’s a written procedure on this matter. Additional pain relief is provided by the District Nurse if prescribed. Junior staff are supported by more senior staff at such times, the Manager said. The staff interviewed told the Inspector that the process is carried out with dignity and that where possible relatives are involved. Holmwood House DS0000062973.V256231.R02.S.doc Version 5.0 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, 15. Residents maintain frequent contact with families and friends, and local community. The home provides a good standard of catering. EVIDENCE: The routines of daily living and activities are based on the choice and preferences of the resident. The Manager said that the time of getting up or going to bed depends on the choice of the resident. The home now has an activities organiser who attends on Monday and Friday, and provides a range of activities. These include, exercises, making things for Christmas, Bingo, and a Cheese and Wine party was recently held. There has been an increase in activities since the last inspection and this has been welcomed by the residents. This was confirmed by both residents and staff interviewed. Religious celebrations take place. Holmwood House DS0000062973.V256231.R02.S.doc Version 5.0 Page 12 Visitors may visit the home at any reasonable time, avoiding meal times if at all possible. Views of residents who may not wish to see visitors are respected. Visitors may meet the residents in their own room , or in one of the communal rooms. Residents are taken into town, or places of local interest, by their relatives, and residents interviewed confirmed this. Staff interviewed are aware of the importance that visitors play in the life of residents. A number of residents introduced the Inspector to their visiting relative. The menus were seen by the Inspector, they appeared varied, nutritious and interesting. Special diets are recorded, and provided. In the inspection dated 9/5/05 a requirement was made that special diets should be recorded, this is now done and the Inspector saw a copy of them. Residents interviewed said that the meals were very good and gave several examples of this, adding that “there’s always enough” they are always nicely set out. Staff interviewed said that they thought the meals provided were good. Drinks and small refreshment are provided at night if wanted. Drinks are provided during the day, and the Inspector saw this in process. Holmwood House DS0000062973.V256231.R02.S.doc Version 5.0 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): 18 The home has an Adult Protection Procedure in place, which is known to staff. EVIDENCE: The Manager informed the Inspector that there had not been any cases of Adult Abuse since the last inspection. The home’s Adult Protection Procedure was seen by the Inspector. Staff interviewed knew of the procedure and what steps to take if they suspected that an abuse of any type were taking place were . At present the Manager has not had any specific training in this matter and because of the importance of this the Inspector requires that this training be undertaken within the next six months. Following this, training for all staff should be provided. Holmwood House DS0000062973.V256231.R02.S.doc Version 5.0 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): 24, 25 The residents rooms are of a high standard and they are improving. Residents rooms are safe and comfortable EVIDENCE: A wide range of residents’ rooms were seen by the Inspector. The rooms were neat, clean, tidy, and free of odours. Residents have furnished their rooms with ornaments, photographs, and other personal objects. they told the inspector that they thought their rooms were very nice and visitors said the same. The state of decoration and furniture is good. As rooms become available they are redecorated. In one room mobile screens have been replaced with curtains which have enhanced the look of the room and made the room safer in that residents can not trip over the screens. This fulfils a recommendation made in the last report. In the report dated 9/5/05 it was required that hot water pipes be covered, this has since been done and the protective wood work was seen in place. This fulfils the requirement made. Holmwood House DS0000062973.V256231.R02.S.doc Version 5.0 Page 15 The Inspector recommends that new name plates be fitted to the doors of residents’ rooms. The heating, lighting ,water supply, and ventilation of service users accommodation meets the relevant environmental health and health and safety requirements. Rooms are individually and naturally ventilated. Windows conform to recognised standards. Rooms are centrally heated and the heating may be controlled in the resident’s room. Lighting in residents’ rooms meets recognised standards. Emergency lighting is in place. Water is stored at least 60oC, and distributed at 50oC. Valves which prevent scalding are in place. Holmwood House DS0000062973.V256231.R02.S.doc Version 5.0 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): 30 The home has an NVQ training programme in place. Staff are trained to do their job. EVIDENCE: There are 12 members of staff who have completed NVQ 2, with a further 5 now on the course. There are 2 members of staff who have NVQ 3.The staff are commended for this and are encouraged to continue. Staff interviewed told the Inspector that they had learnt a lot from the NVQ programme. As yet the home has not achieved the 50 ratio of staff having NVQ training. It is recommended that the NVQ programme continue. The Manager outlined the training provided . An induction programme is undertaken by all staff which meets NTO specification. Five staff have undertaken First ‘Aid training, Moving and Handling, Food Hygiene and Fire Prevention Training. Infection Control and Nutrition Training. It is intended to provide training in using the new care plans prior to them being implemented. A plan of training is to be developed by the Manager. Holmwood House DS0000062973.V256231.R02.S.doc Version 5.0 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 & 36 The Manager needs to undertake Management Training. The home has an in-house Quality Assurance system in place. Residents’ financial interests are safeguarded Supervision does not take place. EVIDENCE: The Manager has been in post since 1990. She communicates with a clear sense of direction and leadership. The process of running the home is open and transparent The Manager complies with the Code of Practice published by the General Social Care Council. The Manager intends to undertake her NVQ 4 and it is required that she does so. Holmwood House DS0000062973.V256231.R02.S.doc Version 5.0 Page 18 The home monitors the quality of the services it provides, and the Inspector was shown the documentation used. The system consists of three sets of questionnaire, which are sent out to residents, relatives and professional visitors to the home. This provides a picture of how the services are viwed.Attention can then be paid to areas which are not satisfactory. The Manager said that the paperwork for the supervision of staff was now ready but as yet the process had not been implemented. In the inspection dated 9/5/05 it was recommended that supervision be commenced. This has not happened and is now a requirement. The home holds money on behalf of residents. These records were seen by the Inspector. The monies are neatly recorded, and they are kept in separate containers. The content of two containers was counted and found to be correct against the record, in the residents cash book. Monies are kept in a locked container but this needs to be kept more securely. The record of expenditure is neatly recorded, with the article purchased, name, the amount and date. It is recommended that numbered receipts are provided when monies are handed in. Holmwood House DS0000062973.V256231.R02.S.doc Version 5.0 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 3 3 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 3 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 2 x x x x x 2 3 x STAFFING Standard No Score 27 x 28 2 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 3 x 3 1 3 x Holmwood House DS0000062973.V256231.R02.S.doc Version 5.0 Page 20 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 23 Standard OP18 OP31 OP36 Regulation 13 (6) 9 (1) 18,2 Requirement It is required that the Manager undertake training in Adult Abuse Protection It is required that the manager number NVQ 4. It is required that the Manager commence supervision for staff. Timescale for action 06/11/06 06/01/06 21/11/05 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 3 4 Refer to Standard OP3 OP9 OP24 OP28 Good Practice Recommendations It is recommended that an assessment of mental health form part of the pre-admission assessment. It is recommended that the home purchase a larger Controlled Drug Cupboard. It is recommended that new name plates be fixed to the doors of residents’ rooms. It is recommended that the NVQ training continue. Holmwood House DS0000062973.V256231.R02.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 House DS0000062973.V256231.R02.S.doc Version 5.0 Page 22 - 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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