Inspection on 21/12/05 for Holmwood Residential Home

This inspection was carried out on 21st December 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 Residential Home 08/01/07

Holmwood Residential Home 22/07/05

Holmwood Residential Home 24/01/05

Holmwood Residential Home 31/08/04

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 Residential Home 37 Upper Olland Street Bungay Suffolk NR35 1BD Lead Inspector Deborah Seddon Announced Inspection 21st December 2005 10:00 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 Residential Home DS0000024420.V259076.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 Residential Home DS0000024420.V259076.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Holmwood Residential Home Address 37 Upper Olland Street Bungay Suffolk NR35 1BD 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) 01986 892561 01986 896030 sandra@holmwood-bungay.co.uk Mr Nicholas John Willoughby Sheldrake Mrs Sandra O`Grady Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (32) of places Holmwood Residential Home DS0000024420.V259076.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd July 2005 Brief Description of the Service: Holmwood is registered to meet the needs of older people and is situated in the small market town of Bungay. The home, which has been owned by the Sheldrake family since 1977, is in well cared for gardens and close to local shops and amenities. The house has been significantly extended twice since 1992 and now offers accommodation for thirty-two residents. The final phase of building work is taking place to offer new bathing, clinical and laundry facilities. The renovations to the dining room and new kitchen are completed and these facilities are in use. Holmwood Residential Home DS0000024420.V259076.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, which took place over five hours on a weekday in December 2005. The inspector spent time with the manager to discuss progress on requirements from the previous inspection in July 2005. A tour of the premises was made and a number of records were examined including the pre inspection questionnaire and those relating to the care of residents, staff and a selection of policies and procedures and a quality assurance analysis. The inspector spent time talking with three staff and with five residents individually and two relatives who were visiting the home on the day of the inspection. The inspector also had the opportunity to speak with a medical professor visiting a resident. Commission for Social Care Inspection (CSCI) feedback cards were sent to the home before the inspection. This gave the residents, relatives and visitors the opportunity to make comments on how they thought the service was run. Comments from eleven completed relatives and visitors cards and twenty residents cards were received. The majority had positive feedback with the exception of two relatives and one visitor who thought the standard of cleanliness around the home had declined in recent months. However these did acknowledge that considerable refurbishment had been taking place. Comments from the feedback cards have been included within this report. What the service does well: Holmwood gives prospective residents a chance to try out the home and provides them with detailed information about the service so that people can make an informed choice of whether this is the right home for them to move into. People living in the home are provided with good access to healthcare services and have detailed care plans in place, which reflect their ongoing needs and the level of support they require. Comprehensive risk assessments were seen on the individuals care plans assessing the risks to their health and welfare. These were specific to the individual and were being reviewed on a regular basis to reflect their changing needs. The home provides a good range of activities that reflect the expectations, preferences and capacities of the people living in the home. Daily routines were geared around the resident’s choices; residents spoke of having the freedom to go out if they wanted to into town and the shops or for a walk. Feedback from residents and relatives was generally very positive about the home comments ranged form ““staff are very good, the food is good with plenty of fresh vegetables and I am able to get out to go to the shops when I Holmwood Residential Home DS0000024420.V259076.R01.S.doc Version 5.0 Page 6 want”. One relative commented, “The home was recommended to us, all staff are very nice and approachable” and “we are very pleased with the home, we are always made welcome”. Feedback from a relatives comment card stated, “My relative is needing more care than before, this is offered with great willingness and care and the staff are regularly commented on by my friends and relatives”. Residents and relatives were generally positive about the food available comments made to the inspector included “Food is very good, I am a bit of a connoisseur as I used to do a lot of cooking for myself” and “ the food is very good, there are plenty of fresh vegetables”. A resident seen enjoying lunch with their spouse commented, “Lovely food, it is beautiful and I enjoy it” What has improved since the last inspection? What they could do better: The home’s recruitment process must demonstrate that a protection of vulnerable adults check (POVA 1st) is obtained prior to any member of staff is employed in the home which can be supported by a criminal record bureau (CRB) check. The manager has previously acted on incorrect advice from the Commission for Social Care Inspection (CSCI) and had started a member of staff in employment prior to obtaining the required checks. Please contact the provider for advice of actions taken in response to this Holmwood Residential Home DS0000024420.V259076.R01.S.doc Version 5.0 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Holmwood Residential Home DS0000024420.V259076.R01.S.doc Version 5.0 Page 8 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 Residential Home DS0000024420.V259076.R01.S.doc Version 5.0 Page 9 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): 1,3,4,5,6, Prospective residents have the opportunity to visit the home and receive detailed information in the statement of purpose and service users guide to enable them to make decision about where they want to live. Residents can expect to have a completed detailed assessment of their needs prior to moving into the home. EVIDENCE: The statement of purpose and service user guide was seen, which had been updated in December 2005. These documents meet the requirements of the National Minimum Standards (NMS) and provides prospective residents with a detailed account of the home and what service they provide. The care plans of three service users were looked at. Evidence was seen that all three had a completed pre admission assessment. These consisted of 16 sections, which contained key information about the service users background, general health, psychological and physical well-being, current care needs and their social interests and hobbies. All the information from the pre admission assessment formed the basis of the individual service users care plan. Holmwood Residential Home DS0000024420.V259076.R01.S.doc Version 5.0 Page 10 The home is registered for older people. The inspector and manager discussed feedback made in a relatives comment card, which suggested their spouse had dementia. The home is not registered for people with dementia and would need to make an application for a variation to the registration should they take any resident into the home with dementia. If the resident is already living in the home and diagnosed with dementia the manager was informed that they do not need to make a variation. However, the inspector discussed with the manager that they need to demonstrate in the statement of purpose and service user guide that Holmwood has a person diagnosed with dementia living in the home and will need to outline the impact this may have on prospective residents and existing residents. They will also need to demonstrate that the staff have recieved training in dementia care and the residents care plan is reviewed to reflect changes in their needs. Holmwood does not provide intermediate care, however the inspector met a resident staying in the home for respite during the Christmas holidays. They told the inspector that they had only been at the home for five days and that they were very impressed, and commented, “staff are very good, the food is good with plenty of fresh vegetables and I am able to get out to go to the shops when I want”. The resident has decided that following this trial period they will be making arrangements to sell their home and move into Holmwood on a permanent basis. Holmwood Residential Home DS0000024420.V259076.R01.S.doc Version 5.0 Page 11 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): 7,8,9,10, Residents can expect to have their health, personal and social needs identified, monitored and met and have access to healthcare services. They can also expect to be protected by the home’s procedures for administering medication and have their privacy and dignity upheld. EVIDENCE: The home uses a medical practice situated in Bungay. They had requested a doctor to visit the home to see a resident who was not feeling well. The inspector arrived as the doctor was making arrangements to admit the resident into hospital and had the opportunity to speak with the doctor to obtain their views of the home. The doctor is a professor who has had experience of the service provided by the home both personally and on a professional level. They informed the inspector that a relative had lived in the home and they had been extremely satisfied with the service provided. As a medical professor they felt the staff at the home had a lot of experience of the residents needs and were very caring and supportive. Holmwood Residential Home DS0000024420.V259076.R01.S.doc Version 5.0 Page 12 During the inspection the care of three residents was tracked. This involved looking at their care plans and spending time with the residents individually and with two relatives of the residents who were visiting. The care plans covered all aspects of the resident’s health, personal and social care needs. The care plan identified areas of need and gave further information about the assistance care staff should provide. For example one resident was assessed as needing help with their food and meal times. The details and level of support needed by the resident and how staff should assist them were recorded. They stated that the resident enjoyed small meals and was not keen on meat or fish. The plan instructed staff to make sure the resident’s food was cut up into small pieces, and were to be aware that the resident was sometimes a little sick after their meal. The objective stated that all staff were to ensure that resident was offered an alternative to meat and fish and was given the support required for them to enjoy their meal in the comfort of their own room. This was the resident’s choice. The care plans contained detailed risk assessments to promote the residents health. These included falls, moving and handling and pressure area care. One resident had been having reoccurring falls, which had increased significantly in the last week. The resident was very restless at night and frequently kept getting in and out of bed to access the toilet and had fallen on several occasions. The resident’s health had been discussed with the district nurse. A possible cause was a recent increase in medication; this has been reviewed by the general practitioner (GP) who is monitoring their condition. The risk assessment reflected that the use of bedrails would not be suitable and a mattress had been placed on the floor next to the resident’s bed. It was noted that although this would not prevent the resident falling the mattress would act as a safeguard to reduce the risk of injury. Evidence was seen in another residents care plan that a risk assessment had been completed for the management of pressure area care. The resident had developed a pressure sore and in line with the homes policy for dealing with pressure sores the district nurse had been contacted. The care plan showed that the district nurse was coming into the home on a regular basis to redresses the pressure sore and was giving advice to staff on the course of action to follow to improve the residents mobility. Evidence was seen that the care plans and risk assessments were being reviewed on a regular monthly basis or as circumstances changed. A requirement made at the last inspection in July 2005, was for care plans to be developed to include residents psychological and social needs. Evidence was seen on one residents care plan that a psychological need had been identified and gave details of support required by staff. For example, the resident has bouts of depression, due to not receiving visitors. The plan states staff are to give encouragement and support when the resident is depressed and encourage them to talk and chat with other residents and staff. Their social Holmwood Residential Home DS0000024420.V259076.R01.S.doc Version 5.0 Page 13 needs identified that the resident preferred to spend time alone in their room; staff were to encourage the resident to join in the activities provided. Each medication administration record (MAR) chart had a front cover with the residents name and a photograph for identification. Holmwood uses Moss pharmacy monitored dosage system (MDS) for all the residents prescribed medicines. A senior member of staff was seen administering medication appropriately and in line with good practice. The medication and MAR charts are held in a medication trolley. Eye drops seen had the date of opening to ensure that they were not being used passed the prescribed expiry date. One resident MAR chart reflected that they chose to administer their own creams. A risk assessment had been completed to assess the risk and to support the resident’s decision. Throughout the day the inspector observed staff knocking on residents doors and waiting before entering their room. Interactions between residents and staff were friendly and appropriate. Residents spoken with felt that the staff treated them with respect and dignity. The inspector observed one resident opening their post which been laid out unopened in the dining room where they usually sat for their meals. Residents were observed being called by their preferred name, which was confirmed in their care plan. Holmwood Residential Home DS0000024420.V259076.R01.S.doc Version 5.0 Page 14 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): 12,13,14,15, Residents can expect to live in a home that supports a life style that matches their needs. Residents can expect to receive a good standard of fresh and appealing food with a wide variety of choice as part of their daily diet. EVIDENCE: A list of activities available to the residents throughout December was on display in the entrance hallway. These ranged from a Christmas party, Marvin’s armchair exercises, Roger Eno entertains, fun with Frances, (the manager explained this is a cognitive word association therapy group). A company based in Bury St Edmunds had visited the home to put on a Pantomime of Cinderella, which had a modern theme and was spoken of very highly by residents who thought the production was very good. They had also held a Christmas fair selling Christmas cards. Residents spoken with were very positive about the home’s activities, one resident spoke enthusiastically about the armchair exercises and the ‘fun with Frances’ sessions, they told the inspector that they are involved in making up letters and words and enjoyed playing quiz games. They also enjoyed spending time in their room watching the cricket on their own television and reading their newspaper. Residents also spoke of having the freedom to go out if they wanted to into town and the shops or for a walk. Holmwood Residential Home DS0000024420.V259076.R01.S.doc Version 5.0 Page 15 Relatives and friends of residents were observed visiting throughout the inspection. The inspector had the chance to speak with two relatives visiting and both were very positive about the care their relatives receive in the home. They told the inspector “The home was recommended to us, all staff are very nice and approachable” and “we are very pleased with the home, we are always made welcome”. Feedback from a relatives comment card stated, “My relative is needing more care than before, this is offered with great willingness and care. The staff are regularly commented on by my friends and relatives”. One resident spoken with had brought some of their own belongings, they had only requested to keep the bed provided and another resident told the inspector they could have brought their own furniture if they had wanted to. They had brought their own kettle so they could make tea and coffee in there room. The home has undergone a programme of significant refurbishment, which included the kitchen. The kitchen has been opened up and fitted with new equipment providing a large and spacious area for the cooks to store, prepare and cook food. The fridge’s and freezers were seen and the temperatures were being monitored and recorded and were seen to be within the safe limits for storing food. Food was being stored correctly in line with good food hygiene regulations with labels indicating the use by dates. A selection of foods was seen including fresh fruit and vegetables. The cook informed the inspector of the choice of food available for lunch and tea on the day of the inspection. The menu consisted of Chicken casserole or gammon or vegetarian bake, accompanied by a choice of vegetables broccoli, parsnips, green beans and mash potatoes, followed by lemon meringue pie or fresh fruit. For tea residents had a choice of sandwiches or soup, with home made cakes, artic roll or fruit. The cook was seen making mince pies; and informed the inspector all cakes were homemade. All food seen during the inspection was nicely presented and looked appealing and appetising. Residents generally spoke positively about the food with comments “Food is very good, I am a bit of a connoisseur as I used to do a lot of cooking for myself” and “ the food is very good, there are plenty of fresh vegetables”. A resident seen enjoying lunch with their spouse commented, “Lovely food, it is beautiful and I enjoy it” Holmwood Residential Home DS0000024420.V259076.R01.S.doc Version 5.0 Page 16 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, People using the homes complaints procedure can expect to have their concerns listened to and receive an appropriate response and be protected by the homes policy and procedure for dealing with allegations of abuse. EVIDENCE: Neither the home nor the Commission for Social Care Inspection has received any complaints since the previous inspection in July 2005. The home has a detailed complaints procedure in place, which promises a detailed response to any complaints within five days of receipt of the complaint. It also refers residents and relatives to the Commission for Social Care Inspection (CSCI) and gives the address and telephone number. A requirement from the previous inspection was for the protection of vulnerable adults policy to be amended to reflect the up to date county processes for reporting incidence of abuse. The policy was seen which had been amended to include the address and telephone number for the customer first team in line with the Suffolk vulnerable adult protection committee (VAPC) inter agency policy. The requirement also related to all staff receiving training in the protection of vulnerable adults. All staff are scheduled to attend training on the 16th January 2006. A member of staff has attended a train the trainer session at Kerrison training centre and will be cascading refresher adult protection training in house to all staff. Holmwood Residential Home DS0000024420.V259076.R01.S.doc Version 5.0 Page 17 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): 19,20,21,22,24,25,26, Residents can expect to live in a well-maintained environment and welcoming environment, which provides a good range of communal and personal accommodation with their own possessions around them. EVIDENCE: Holmwood is situated within walking distance of Bungay town centre, a library and a local community centre. The home offers seventeen single en-suite rooms and two double en-suite rooms. They also provide one double and nine single rooms that do not have en-suite facilities. As part of a recent refurbishment of the home, two new fully assisted bathrooms have been installed and four new toilets. All bathrooms and toilets have been fitted with grab rails. The Kitchen and dining room have been refurbished providing large and spacious facilities that have been tastefully decorated. There are three lounges that residents can choose from, one has a television. Residents were observed watching television and engaging in conversation during the inspection. Further decoration has taken place to corridors, bathrooms, the new laundry facilities and an old bathroom has been made into a hairdressing salon. Holmwood Residential Home DS0000024420.V259076.R01.S.doc Version 5.0 Page 18 Outside the gardens are very attractive and nicely kept. To the rear of the property a new patio area has been created with a water feature and new decorative fencing to the front and rear of the property. Residents spoken with liked the new decorations to the home. The inspection took place a few days prior to Christmas; staff had decorated the home beautifully throughout with Christmas trees and matching decorations, which created a festive atmosphere. The care plan of one resident showed they had been assessed for needing bedsides. They are unable to mobilise independently and have been assessed as a high risk of falling from the bed. The home has sought guidance from the general practitioner (GP) for the use of bedrails as the resident presents as confused and is unable to give their permission. Evidence was seen that equipment to meet the needs of the residents was being provided. The inspector observed a resident being transferred using a standing hoist as recommended in their moving and handling assessment in their care plan. Two staff were observed supporting the resident to transfer and showed patience, care and respect with the resident whilst carrying out the move from arm chair to wheelchair. The resident had been assessed at the James Padget hospital and provided with a suitable wheelchair. A selection of residents rooms were seen and all looked clean, tidy and comfortable and personalised with some of the resident’s own belongings. Two residents spoken with informed the inspector that they had a lovely room and a third resident said, “I have a nice comfortable room”. All residents have the opportunity to have a key to their room and lockable cabinet within the room. Residents who do not wish to use the keys sign a statement, which is held in their care plan. A second phase of refurbishment to the original former entrance hall and stairwell are to commence in the spring 2006. Also a programme of fitting handrails in all corridors to assist residents with partial sight will coincide with the refurbishment. The new laundry facilities are situated away from areas where food is prepared and eaten and lead out into a courtyard so that laundry can be hung out to dry in good weather. Both washing machines have a sluice cycle and staff use red dissolvable bags to separate and deal with soiled linen. There are plans replace the existing tiles in the spring. All areas of the home were clean, hygienic and free from unpleasant odours. Corridors seen were tidy and free from obstruction and all radiators are fitted with radiator covers. Hand washing facilities are available around the home equipped with paper towels and liquid antibacterial soap available. Holmwood Residential Home DS0000024420.V259076.R01.S.doc Version 5.0 Page 19 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): 27,28,29,30, Residents can expect to be cared for by a team who are available in sufficient numbers, who have the skills and knowledge to care for them. However, residents cannot expect to be protected by the homes recruitment practices. EVIDENCE: The staffing levels for the day of the inspection were discussed with senior member of staff; the numbers were supported by information in the pre inspection questionnaire. The senior carer was working an early shift between the hours of 6.45am to 2.15pm supported by two carers working between 7am to 2pm and another carer working between 7am to 11.30am. For the late shift a senior carer was rostered to work 2.00pm to 9.30pm supported by two staff working between 2pm to 9pm. The home has two cooks and two kitchen assistants that work on a rota basis between split hours, which cover 7am to 6.30pm. There are two domestic staff and two laundry staff who cover the hours between 8.30am to 1pm. Staff spoken with felt that the number of staff on duty were sufficient to meet the needs of the residents. Staff spoken with confirmed that they had either completed a national vocational qualification (NVQ) at level 2 or 3 and another said they had started their level 3 in November 2005. The pre inspection questionnaire reflects that the home has sixteen care staff in total of which fifteen (99 ) hold an NVQ at level 2 or above. Holmwood Residential Home DS0000024420.V259076.R01.S.doc Version 5.0 Page 20 The recruitment and selection process for new staff was inspected. Two staff files seen contained all the necessary checks, including a criminal records bureau check (CRB), protection of vulnerable adults (POVA 1st) and two satisfactory references. However the third file showed that an overseas member of staff had been recruited on the 29th November 2005, but did not have a protection of vulnerable adults check requested until the 6th December 2005. The completed criminal records (CRB) check returned on the 16th December 2005. A discussion took place with the manager about the recruitment process. They told the inspector that a previous regulation inspector had informed them that there was no point in seeking a CRB for a person from abroad as the person would not have a criminal record in this country, nor would they appear on a protection of vulnerable adults (POVA) list. The manager said the agency would have already checked their criminal history in their own country of origin before coming to the United Kingdom. Therefore the manager, acting on advice from the Commission for Social Care Inspection (CSCI) started this member of staff in employment. However, guidance for the checks on staff recruited from abroad states that regulated services where there is a specific regulation that requires all staff working in the home must have a CRB checked including staff recruited from abroad. All three files seen had a completed terms and conditions of employment. Evidence was seen on one staffs file that they had completed the sector skills council for social care (TOPPS) induction and foundation training. A record of other training covered fire safety, moving and handling, health and safety, infection control and first aid. Holmwood Residential Home DS0000024420.V259076.R01.S.doc Version 5.0 Page 21 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): 31,32,33,35,36,37,38, Residents can expect to live in a home that is well managed and have their healthy, safety and welfare protected. The results of the quality assurance survey show that residents are happy with the service they receive. EVIDENCE: The registered manager is a qualified registered nurse and registered midwife and has a master’s degree in health and sciences and a bachelor (honours) degree. They have also completed the national vocational qualification (NVQ) level 4 managers award. The manager informed the inspector that they keep up to date with current practice; they are currently still registered with the national midwifery council and attends all mandatory training, for example health and safety and moving and handling. The inspector spoke with three staff individually and as a group. They had a range of experience working in the home. They felt there was a good core of staff that had worked at the home for a long time. They fely the new staff Holmwood Residential Home DS0000024420.V259076.R01.S.doc Version 5.0 Page 22 added additional strengths and that they all worked well as a team. Staff spoke of changes that had occurred within the home during the past few years and the introduction of the new manager. They felt supported by the management team and said the manager was approachable and had an open door if they had any problems. Holmwood has a quality management system in place. This is made up of a series of policies and procedures, which reflect consultation with residents living in the home. The inspector was shown the result of the most recent residents survey. The survey covered entertainment, food, atmosphere of the home and staff, residents choice, cleaning and laundry service and general issues, for example do residents have the opportunity to express their views about the home. The results reflected that users of the service were very satisfied with the service they receive. Seven residents are supported to handle their own financial affairs. One resident spoken with informed the inspector that their relative was their power of attorney who looked after their financial arrangements, but kept some money for purchasing small day-to-day items. All residents’ have a lockable cabinet in their room for locking small amounts of money and personal items. The manager informed the inspector that some residents chose to have their money locked in a safe in the office. Each resident has a separate moneybag, which is individually labelled and has a folder with an account of their spending record; all entries and withdrawals are recorded and two signatures obtained. Evidence was seen that staff receive supervision and have regular staff meetings. This was confirmed during the conversation with staff who informed the inspector that they had attended a recent staff meeting on the 7th November 2005. A requirement at the previous inspection in July 2005 was for a supervision programme for ancillary staff to be implemented to monitor their training needs and competence. The file of one of the laundry assistants was seen and showed that they had signed a supervision agreement and had had one supervision session in September 2005 where they had discussed with their supervisor work performance, future targets and training required for future carer and personal development. Evidence was seen on residents care plans that individual risk assessments had been carried out to assess the risk of the resident’s security if living above ground floor. The risk assessment showed that safety catches had been fitted to prevent the window opening to far. Risk assessments had also been done to assess the risk of residents burning themselves on uncovered radiators; radiator guards have now been installed. The pre inspection questionnaire shows that the home keeps detailed records of maintenance within the home and has policies and procedures in place to protect the health and welfare and safety of the residents. Holmwood Residential Home DS0000024420.V259076.R01.S.doc Version 5.0 Page 23 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 X 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 X 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 3 3 Holmwood Residential Home DS0000024420.V259076.R01.S.doc Version 5.0 Page 24 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 Standard OP29 Regulation 19,1 Sch 2 (7) Requirement All staff employed in the home including staff from abroad must have the appropriate CRB checks and all other information required in schedule 2 and records kept on file. Timescale for action 31/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Holmwood Residential Home DS0000024420.V259076.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 Residential Home DS0000024420.V259076.R01.S.doc Version 5.0 Page 26 - 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!