Inspection on 08/11/05 for Holmwood House

This inspection was carried out on 8th November 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 05/05/05

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 40 Whitecross Road Swaffham Norfolk PE37 7QY Lead Inspector Mr Christopher Handley Unannounced Inspection 8th November 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 DS0000062972.V263960.R01.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 DS0000062972.V263960.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Holmwood House Address 40 Whitecross Road Swaffham Norfolk PE37 7QY 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) 01753 643106 Integrated Nursing Homes Limited Mrs Ann Elizabeth Chilvers Care Home 44 Category(ies) of Old age, not falling within any other category registration, with number (44), Physical disability (4) of places Holmwood House DS0000062972.V263960.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th May 2005 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 GP centre. The home is within easy walking distance of the town centre of Swaffham. Holmwood House DS0000062972.V263960.R01.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 part of the annual inspection programme 16 Standards were inspected, The inspection commenced at 09.30am and was completed at 4pm. There were 44 residents in the home on the day of the inspection, 11 in receipt of residential care and 33 in receipt of nursing care. A full tour of the home was undertaken. Five members of staff and four residents were interviewed and several residents were spoken to informally. One visiting professional was interviewed. Mrs A Chilvers, Manager, was present throughout the day and was helpful in facilitating the inspection. During the day the Inspector met with Mrs Ruth Hayes, Regional Manager for Integrated Nursing Homes. What the service does well: What has improved since the last inspection? • • • The decoration of the environment continues to improve. There has been a big improvement in the care planning. The readability of contracts has improved. Holmwood House DS0000062972.V263960.R01.S.doc Version 5.0 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 House DS0000062972.V263960.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Holmwood House DS0000062972.V263960.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, & 5 Prospective residents and their relatives are provided with a range of information about the home. All residents have a Contract/Terms and Conditions. Prospective residents and their relatives are welcomed to visit the home prior to admission. EVIDENCE: The Manager said that all residents are provided with a copy of the Service Users Guide, and Statement of Purpose. Copies of both documents were seen and briefly read by the Inspector. They contain all the information required and are in a print size which makes them easy to read. These documents are in a brochure which has a very nice picture of the home on the front. Staff and residents spoken to were aware of these documents. Holmwood House DS0000062972.V263960.R01.S.doc Version 5.0 Page 9 All residents have a Contract/Statement of Terms and Conditions, the Manager said. The Manager reads through the document with the residents to ensure their understanding of the content. The residents are supplied with a copy, and a signed copy is kept in the office. In the Inspection dated 5/5/05 it was recommended that the print size be increased in order to assist those people who may have poor sight. The copy seen by the Inspector had been printed in a lager size print and it makes much easier to read. Some of the staff interviewed were aware that residents have contracts and were aware that these are legal documents. One of the residents interviewed was aware that she had signed her contract soon after she came into the home. Mrs Chilvers said that she is very much aware of the importance for residents and their relatives to visit the home prior to admission so that they get to see, and find out as much as they can, about what may be their future home. These visitors are taken around the home, meet and talk with residents and staff and have the opportunity to ask questions. Holmwood House DS0000062972.V263960.R01.S.doc Version 5.0 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 the following standard(s): 7,9,& 10 All residents have an individual care plan. The home has an effective and safe medicine system. Residents said that they are treated with respect and that their privacy is always upheld. EVIDENCE: All residents have an individual care plan which is kept in a folder and is clearly marked “Confidential” Three sets of care plans were examined. In the report dated 5/5/05 it was recommended that the Manager and Regional Manager undertake a major review of the care planning system so as to ensure that it becomes a more effective system. This has taken place, and there is now a new system which is more effective. Prior to the implementation, training took place to ensure that all staff understood how to use the new system. The staff like the new system and have worked hard to implement it. This is commended. Holmwood House DS0000062972.V263960.R01.S.doc Version 5.0 Page 11 The home maintains a Daily Record, and whilst the entries are appropriate they are some what brief and this could be improved. The Inspector advised that the Manager, and Regional Manager, develop some guidelines for staff to use when writing this record, so that the record is neither over long or too short. To assist the effective use of these care plans the Inspector recommends that two mobile record cabinets, with lockable lids be purchased, so that they can be moved to the place where the consultation takes place, e.g. in a residents room. When not in use these trolleys should be kept locked to the wall. The Manager showed the Inspector the medicine system. The medicines are kept in a designated room which is kept locked when not in use. This room is adequately ventilated. The home has clear and effective arrangements in hand to deal with any medicines which might be brought in by residents and the Manager explained this to the Inspector The medicine trolley was locked and in turn was locked to the wall. The inside of the trolley was neat, clean, and tidy and there were no loose or unaccounted for medicines. Only trained nurses administer medicines in this home and also hold the keys of the trolley, the medicine room, and the Controlled Drug Cupboard. The records of administration were seen , and the entries were legible, dated and initialled, and no gaps were seen .The home has a comprehensive medicine procedure which was briefly seen by the Inspector. There are no residents who self medicate, the Manager said. The home has a drug refrigerator, which was free of ice. One Controlled Drug was counted and found to be correct against the register. The home enjoys a good working relationship with the supplying pharmacist. If staff had any concerns about the effect of medicines on residents they would contact the prescribing doctor. Medicines are reviewed on a regular basis and this is recorded. Staff interviewed said that residents were treated with respect and that their privacy was protected. In the Inspection dated 5/5/05 mention was made that some residents felt that their privacy was not respected. However, at this inspection residents stated that staff did respect their privacy and dignity. The Inspector frequently observed staff knocking on the doors of residents’ rooms, during the process of the inspection and residents spoken to confirmed this. Privacy forms part of the induction training of staff the Manager said. Holmwood House DS0000062972.V263960.R01.S.doc Version 5.0 Page 12 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): 15 The Home provides a good catering services. EVIDENCE: The home provides a good catering service. The menus were seen by the Inspector they appeared nutritious, varied, and interesting. Special diets are recorded, and provided. Residents interviewed spoke highly of the meals, saying that there was always enough, that there was plenty of variety, and that they tasted nice. The Inspector briefly observed the residents enjoying their midday meal. Refreshments and drinks are always available. Staff interviewed felt that the meals were good. Catering staff have undertaken First Aid training as was recommended in the inspection dated 5/5/05, this training should equip them for any accident which may occur in the kitchen. Holmwood House DS0000062972.V263960.R01.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): 16 & 18 The home has a complaints procedure in place. Residents are protected from abuse. EVIDENCE: The complaints procedure is posted up in the front hall of the home, and was seen there by the Inspector. Staff interviewed were aware of the complaints procedure and the importance of it. Residents interviewed told the Inspector that they were aware of how to make a complaint but added that they would ask the first member of staff who they spoke to, about it. There have not been any complaints since the last inspection the Manager said. The Manager described the good practice of the home in this matter which consists of dealing with minor concerns quickly, and thus preventing these minor concerns developing into complaints The home has a policy on Adult Abuse, and staff have taken training about this as part of the TOPPS training. Staff interviewed were very much aware of the importance of preventing abuse and told the Inspector that they would not hesitate to inform the Manager if they had any concerns. Holmwood House DS0000062972.V263960.R01.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 Residents live in comfortable, pleasant rooms. EVIDENCE: The Inspector made a tour of the home accompanied by the Manager and visited most of the residents rooms. All rooms have good natural light with windows which provide views out over the gardens. Residents’ rooms have a wide range of ornaments, pictures and personal items, and it is clear that resident have made a great effort to personalise their rooms. There is a programme of refurbishment for the home which was outlined by the Manager. This consists of re-carpeting, redecoration, and curtains being fitted in the rooms. At present not all rooms have been completed, but those that have are of a high standard and look very much improved since the last inspection. The residents and staff spoke highly of these improvements and the Company is warmly commended for this and is urged to continue with the refurbishment programme. Holmwood House DS0000062972.V263960.R01.S.doc Version 5.0 Page 15 At present there is a mixture of different name plates on the doors of residents’ rooms and the Inspector recommends that some degree of uniformity is introduced in line with the quality of the decoration being done Whilst touring the home the Inspector met with the Regional Manager, who is based at the home. She showed the Inspector a room which has not previously been in use. It is the company intention to completely refurbish this room and apply for it to be registered. The rooms is of a good size, has very good natural light, but there are access difficulties to the room which were discussed. Holmwood House DS0000062972.V263960.R01.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): 27 & 28 The home is adequately staffed for the number of residents in the home at their present dependency levels. There is an NVQ training programme in place. EVIDENCE: The Manager said that there were 2 RGNs, 2 Senior Carers, 4 Carers, 2 induction carers, 1 Diversional Therapist, 3 domestic, 1 Cook, 2 Catering Assistants, 1 Administrative Assistant and the Manager on duty on the morning of the inspection. The off duty showed this level of staffing, which in the opinion of the Inspector meets the residents’ present needs. Although the present staffing level meets the present needs of residents the Manager is advised to monitor the dependency of residents. In the Inspector’s opinion, based on informal observations of the residents during the day, it is his opinion that their dependency had increased since the inspection dated 5/5/05. Holmwood House DS0000062972.V263960.R01.S.doc Version 5.0 Page 17 The Manager said that there were 8 members of staff who have NVQ II, there 2 who are taking NVQ II, and 5 members of staff have applied to take NVQ II. There is 1 member of staff who has NVQ III, and there are 2 members of staff who will be applying to take NVQ III. The staff who are undertaking their NVQ are commended for doing so, the Inspector is aware that it can be difficult to undertake training for people who lead busy lives. The Manager and the Company are commended for developing the skills of staff which will ensure that the residents receive a good quality of care. Holmwood House DS0000062972.V263960.R01.S.doc Version 5.0 Page 18 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): 31,33,36,& 37 The Manager is fit to be in charge and is an effective Manager. The Manager monitors the quality of the services provided. Staff receive supervision. Residents’ records are kept secure. Holmwood House DS0000062972.V263960.R01.S.doc Version 5.0 Page 19 EVIDENCE: Mrs Chilvers, the Manager of the home, is a qualified RGN, with a Diploma in Management, and has more recently undertaken an management update programme. She holds an ENB Certificate, 998, “Teaching an Assessing in Clinical Practice”. She has worked at the home for eight years. Mrs Chilvers has a job description which clearly outlines the requirements of her post, and this was seen by the Inspector. She has previously held a senior post with the local Health Authority. She is responsible for this home only. She and other senior staff are familiar with the diseases associated with old age. There are clear lines of accountability both within the home and with external management. The home has a system of monitoring the quality of the services it provides. A series of questionnaires are sent out to residents/GPs and families. The questionnaires seek a response on the quality of the services provided. The most up to date questionnaire is then checked against the last one to see if there has been any improvement or deterioration in the services provided, and in this way the Manager a can see if the quality of the services has improved or not. The management of the home should use the questionnaire to develop and Improvement Plan for the home, which is shared with the residents, their families and the Commission. The Manager provides supervision for staff, and this is recorded. The records were seen by the Inspector. Staff interviewed said that they found supervision of a help in that they knew how they were getting on, and that training also featured in their supervision. Records required by regulation were seen by the Inspector as part of this inspection. Residents have access to their records if they wish, but Mrs Chilvers said that none has asked to seem them. Records are kept up to date and are maintained in accordance with the Data Protection Act 1998. Holmwood House DS0000062972.V263960.R01.S.doc Version 5.0 Page 20 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 X X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X X X X 3 X X STAFFING Standard No Score 27 3 28 2 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X 3 3 X Holmwood House DS0000062972.V263960.R01.S.doc Version 5.0 Page 21 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. Standard Regulation Requirement Timescale for action 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 OP9 OP24 Good Practice Recommendations That the home purchase two mobile record cabinets, with lockable lids. The new name plates are put on the doors of residents’ rooms. Holmwood House DS0000062972.V263960.R01.S.doc Version 5.0 Page 22 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 DS0000062972.V263960.R01.S.doc Version 5.0 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!