Inspection on 05/05/05 for Holmwood House

This inspection was carried out on 5th May 2005.

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

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

Other inspections for this house

Holmwood House 13/11/06

Holmwood House 08/11/05

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 40 Whitecross Road Swaffham Norfolk PE37 7QY Lead Inspector Christopher Handley Announced 5 May 2005 9.30am 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 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 I55 S62972 Holmwood House Swaffham V217880 050505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Holmwood House Address 40 Whitecross Road Swaffham Norfolk PE37 7QY 01760 724404 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) Integrated Nursing Homes Limited Mrs Ann Elizabeth Chilvers Care Home 44 Category(ies) of Old Age (44) registration, with number Physical Disability (4) of places Holmwood House I55 S62972 Holmwood House Swaffham V217880 050505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14 September 2004 Brief Description of the Service: Holmwood House is a large Georgian house, with recent extensions, which stands in its own grounds, with a car park at the front of the home. It is a dual registered home, providing both nursing and residential care. The home receives its medical care from the G.P centre. The home is within easy walking distance of the town centre of Swaffham. Holmwood House I55 S62972 Holmwood House Swaffham V217880 050505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, part of the annual programme, 21 standards were inspected. A full tour of the home was carried out. Seven staff, and six residents were interviewed, one of whom required the assistance of the Activities lady, who carried out the signing needed. There were 35 Comment Cards received which provided wide spread views of the home. The Inspection was taken by the Manager Mrs A Chilvers, supported by the Mrs Ruth Hayes, Regional Manager, for Integrated Nursing Homes. What the service does well: What has improved since the last inspection? The appearance of areas of the home. The carpeting in the ground floor corridor has all been replaced, and this has enhanced the appearance of the home a great deal. Twelve of the residents’ rooms have been re-carpeted, and this has enhanced the appearance of these rooms. Holmwood House I55 S62972 Holmwood House Swaffham V217880 050505 Stage 4.doc Version 1.30 Page 6 The appearance of the dining room has been improved with a new floor covering and small items e.g. the provision of serviettes. The nursing desk has been removed. There has been a major improvement in activities in the home since the new appointment was made, the scope and variety of activities is now very good. The Manager’s positive contribution to the Inspection showed that her knowledge of the Care Standards has very much 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 I55 S62972 Holmwood House Swaffham V217880 050505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Holmwood House I55 S62972 Holmwood House Swaffham V217880 050505 Stage 4.doc Version 1.30 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 standard(s) 2, 3 &5 All residents are provided with a Terms and Conditions. A preadmission assessment is carried out on all prospective residents. Prospective residents and their relatives are positively welcomed to visit the home prior to admission. EVIDENCE: All residents are provided with a Terms and Conditions which is an agreement, that informs residents of the services that they will be entitled to. A number of residents spoken to were aware that they had such a document, others said that their relative held it on their behalf. A copy of this document was seen. The Manager reads through this document with the resident and relative, to ensure that they have a clear understanding of the content of the document. A copy is given to the residents/relative, and a signed copy is kept in the office. It is recommended that the print size be increased which will make the document easier to read for people who may have poor sight. Holmwood House I55 S62972 Holmwood House Swaffham V217880 050505 Stage 4.doc Version 1.30 Page 9 The Manager, who is a trained nurse, undertakes a pre-admission assessment on all prospective residents. This ensures that a decision can be made based on the information obtained, as to whether the home can meet the needs of the prospective resident. The form was seen and it contains the essential elements of assessment, namely physical, mental and social well being. It is recommended that the document be headed “Confidential Information” because of the content of the document when completed. These assessments are carried out by arrangement, and identification is carried, which protects the potential resident. All prospective residents and or their relatives are positively welcomed to visit the home prior to admission, the Manager said. They can tour the home, meet staff and other residents, and ask any questions they want about the home. They are provided with a Statement of Purpose and Service users Guide. In this way they can get a full picture of the home and the service it provides prior to them making a decision to be admitted to the home or not. Holmwood House I55 S62972 Holmwood House Swaffham V217880 050505 Stage 4.doc Version 1.30 Page 10 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 standard(s) 7, 8, 9 &10 All residents have an individual care plan but residents are not involved in its creation. Residents’ health care needs are fully met. The medicine system meets the needs of the residents, and they are protected by the homes polices and procedures in this matter. Service users feel that they are treated with respect, but some feel their privacy is not always upheld. Holmwood House I55 S62972 Holmwood House Swaffham V217880 050505 Stage 4.doc Version 1.30 Page 11 EVIDENCE: All residents have an individual care plan, which contains the essential elements of assessment, planning, implementation and review. Three of these documents were read in detail. In the documents read there was no indication of residents being involved in reviews of their care. There is a wide range of assessment documentation, which has been neatly completed. A Daily Record is maintained and the entries seen were dated, legible, and signed. At present some documentation is kept in the residents’ rooms. Residents interviewed were aware that the staff have records about their care. The documents seen lacked clarity, and structure, they tend to be unwieldy, and do not appear to be very workable documents. It is recommended that the Manager and the Regional Manager undertake a major review of the documentation, so as to ensure that they are more effective working documents. The Regional Manager undertook to provide an update training session on care planning, once these changes have been made. The storage of these documents is to be reviewed which will enhance their security, but will ensure that residents will still have access to them if they wish. All residents have a G.P. and this recorded. A wide range of personal and nursing care is provided by the staff of the home. If needed other health care professionals would be called to the home or if appropriate the resident will visit the local hospital or clinic for a consultation or treatment. At present there are two residents who are having treatment for pressure sores, and this is recorded. There have not been any accidents in the home, which required admission to hospital since the last inspection. The medicine system was inspected. The home uses a blister pack system. Only trained nurses administer medicines in this home, they hold the keys of the medicine room and cupboard. There are no residents who self medicate. The home has a comprehensive Medicine Policy which was seen. Based on the information provided the system for the storage, administration, recording, and disposal of medicines is safe. A thermostatic refrigerator was seen and it was not over frosted. There is a Controlled Drug Cupboard and one drug was counted and found to be correct against the Controlled Drug Register. The home enjoys good working relationships with the supplying pharmacist. If staff had any worries about medicines they would contact the prescribing doctor. Medicines are reviewed on a regular basis, and this is recorded. Holmwood House I55 S62972 Holmwood House Swaffham V217880 050505 Stage 4.doc Version 1.30 Page 12 The provision of privacy forms part of the induction of staff, and staff interviewed are aware of the importance of this. Shortly after arrival at the home the Inspector observed that the door of a resident’s room was open, the resident was being provided with personal care, the Inspector discreetly closed the door. A total of 35 Service users Comment cards were received and six of these made a comment about privacy, indicating “No” or “Sometimes”. Residents interviewed said that they thought that as staff were busy “They must have forgotten”. This matter was raised at the feedback and the Manager has undertaken to raise this matter at the next staff meeting, and to monitor the home’s practice in this matter so as to ensure that privacy is upheld on all occasions. Holmwood House I55 S62972 Holmwood House Swaffham V217880 050505 Stage 4.doc Version 1.30 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 & 15 The home has appointed a person who is responsible for activities in the home. Since the appointment of the Diversional Therapist the quality of activities and the social life of the residents has improved. The home provides a good catering service. Special Diets need to be recorded. EVIDENCE: The home has appointed an Diversional Therapist, and since this appointment was made there has been a big improvement in both the quality and content of social activities. A list of activities arranged is posted up in the home. The residents interviewed spoke very highly of the activities provided and of the member of staff who plans and carries them out. If visitors wish, they can be involved as well. Holmwood House I55 S62972 Holmwood House Swaffham V217880 050505 Stage 4.doc Version 1.30 Page 14 There are sessions arranged on an individual or group basis. Staff repeatedly said how much these activities had improved and that they were very much looked forward to. This improvement was reflected in the Comment Cards received. There is now an in-house magazine, a name for which is being sought, which informs the residents of the activities planned. Some of the activities provided range from visits made by the Salvation Army Brass Band, to the Stoke Ferry Stompers! Representatives of religious organisations call to the home on a regular basis. The mobile library visit the home on a regular basis. Numerous visitors were in the home on the day of the inspection and some spoke briefly to the Inspector. The menus were seen, they appear varied, nutritious and interesting. Drinks are available at any time. The cook said that she meets residents shortly after admission to ascertain their individual choices and preferences. At present special diets are not recorded and it is required that they are. Residents spoke very highly of the meals provided “They are always very tasty”, “There is always enough”, “They are always nice and warm” were some of the comments made. The Comment Cards also reflected that residents had a good opinion of the catering services. At present the cook has not undertaken a First Aid course. Holmwood House I55 S62972 Holmwood House Swaffham V217880 050505 Stage 4.doc Version 1.30 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 17 & 18 The home has an effective complaints procedure. The home ensures that the legal rights of residents are protected. Residents are protected from abuse. EVIDENCE: The complaints procedure is posted up in the front hall. It is known to both staff and residents who when interviewed were asked about this matter. Residents were aware that there was a formal process but they said that they would just ask a member of staff or the Manager if they had any concerns. Since the last inspection one complaint has been received. The CSCI had been notified of this. The complaint was thoroughly and speedily investigated by the Regional Manager, and the complaint was not upheld. The legal right of residents are upheld and the Manager said she would facilitate legal advice if needed. On the day of the inspection a number of residents went out to vote in general elections The home has a policy on Abuse Awareness and training has been provided for staff on this matter, and it also forms part of the TOPP’s training. When interviewed, staff were very aware of the importance of this matter. Based on what was said. The Manager and Regional Manager are aware that abuse can take many forms, and that it can start in a very assiduous manner, and are alert to this. Holmwood House I55 S62972 Holmwood House Swaffham V217880 050505 Stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 24 & 26 The home is suitable for its stated purpose. The home complies with the requirement of the local Fire Service and Environmental Health Department. Considerable work has taken place to improve the internal appearance of the home. EVIDENCE: The home is accessible, safe, and well maintained. The residents said that they could make their way around the home, and they were observed doing this during the course of the inspection. The home now has a detailed programme of maintenance and renewal of fabric which was seen. It very clearly identifies both maintenance and new work. The grounds are kept tidy, and a part time gardener has been appointed to ensure that they are maintained to a high standard, for the benefit of residents, whose rooms overlook the gardens. Holmwood House I55 S62972 Holmwood House Swaffham V217880 050505 Stage 4.doc Version 1.30 Page 17 The building complies with the requirements of the local fire services and Environmental Health Department. The home has CCTV cameras for security purposes, but they do not intrude on the daily life of residents. Most of the residents’ rooms were seen during a tour of the home. They were all neat, tidy, and odour free. They are individually furnished with the resident’s own belongings, including ornaments, pictures photographs, etc. The residents interviewed said that they were very pleased with their rooms, and that they were comfortable and warm. All the rooms have good natural light coming from windows which provide views out over the gardens. The rooms are comfortably furnished and there is a wide range of adjustable beds to meet the needs of residents. There are privacy curtains in double rooms. Those residents who wish to do so can lock the door of their room. Twelve of the forty rooms have been re carpeted, and the remainder will be done in the near future. The appearance of the rooms already done has been greatly enhanced by this. The Company is commended for this. The whole of the downstairs corridors have been re-carpeted, this has greatly improved the appearance of the home, it now looks smarter and warmer. The Company is commended for this. The dining room floor has been recovered with a wood laminate flooring, new table clothes are in place, and the nurses desk has been removed. The whole appearance of this room has been greatly improved and this adds to the enjoyment of meal times, as the appearance is now of a high-class dining room. The company are warmly commended for the upgrading of this area. The home was neat, clean, and tidy. The fire doors seen were free of obstruction. The laundry was neat and tidy, there are hand washing facilities in place, the floor is impermeable. The home has the polices and procedures for the control of infection and the safe handling and disposal of clinical waste. The home meets all the elements of Standard 26. Holmwood House I55 S62972 Holmwood House Swaffham V217880 050505 Stage 4.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 28, 29 & 30 The NVQ training needs to continue. The recruitment practice of the home is sound. The home has recognised TOPPS training. EVIDENCE: The Manager said that there were 5 members of staff who have NVQ level II, and another 5 members of staff will have completed this programme by the end of the month. There is 1member of staff who is taking NVQ level 3. The Manager needs to continue to encourage staff to undertake this training. Staff interviewed who had taken this training said how they thought it had improved their skills, and that it made them think why they did things. Based on the documentation seen, and what the Inspector was told, the home has good employment practice, and documentation – Integrated Nursing Homes, which ensures that as far as is possible only suitable applicants are employed, thus ensuring the residents are safe and receive a good standard of care. The home now has an Induction and Foundation training programme which meet TOPP’s specification. Other training provided includes Health & Safety, Fire Training, Moving & Handling Trainers. First Aid, Treatment of Ulcers, Wound Care, Infection Control, Continence Training, Handling of Medicines, and Personal Development. Holmwood House I55 S62972 Holmwood House Swaffham V217880 050505 Stage 4.doc Version 1.30 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34 & 38 The home does not have a Quality Assurance system. The home has detailed financial records. The health, safety and welfare of residents and staff is promoted and protected. EVIDENCE: The home has undertaken a survey of the services it provides, and this was seen. This is a very clearly set out document, as yet this survey has not been collated. The home is pursuing enquires with a view to achieving Quality Assurance status. Holmwood House I55 S62972 Holmwood House Swaffham V217880 050505 Stage 4.doc Version 1.30 Page 20 Detailed financial records were seen which show the current financial viability and efficient management of the Company. These records are very clearly set out, and are up to date. They are stored securely. Appropriate Certificates of insurance were seen. The home now has all the elements required to meet Standard 38. As the home now has training which meets TOPP specification it now meets element 38.9, of Standard 38, which was the only element that it did not meet when last inspected. Holmwood House I55 S62972 Holmwood House Swaffham V217880 050505 Stage 4.doc Version 1.30 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 x 14 x 15 2 COMPLAINTS AND PROTECTION 3 x x x x 3 x 3 STAFFING Standard No Score 27 x 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 x x 2 3 x x x 3 Holmwood House I55 S62972 Holmwood House Swaffham V217880 050505 Stage 4.doc Version 1.30 Page 22 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 15 Regulation 4 Requirement It is required that Special Diets are recorded Timescale for action 1 month 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. 5. 6. 7. 8. Refer to Standard 2 3 7 10 15 Good Practice Recommendations It is recommended that the Terms and Conditions are put in a larger print. It is recommended that the pre-admission document be headed Confidential Information. It is recommended that a major review of the care planning documentation take place, to include training and safe storage. It is recommended that the right is reinforced and monitored. It is recommended that all catering staff should undertake First Aid Training Holmwood House I55 S62972 Holmwood House Swaffham V217880 050505 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection 3rd Floor Cavell House St Crispins House 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 I55 S62972 Holmwood House Swaffham V217880 050505 Stage 4.doc Version 1.30 Page 24 - 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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