Inspection on 15/07/05 for Holt House - The Salvation Army

This inspection was carried out on 15th July 2005.

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

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

Other inspections for this house

Holt House - The Salvation Army 30/07/08

Holt House - The Salvation Army 12/07/07

Holt House - The Salvation Army 05/06/06

Holt House - The Salvation Army 10/02/06

Holt House - The Salvation Army 03/12/04

Holt House - The Salvation Army 28/04/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE The Salvation Army Holt House Headlands Drive Prestwich Manchester M25 9YF Lead Inspector Rukhsana Yates UnAnnounced 15 July 2005 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. The Salvation Army F56 F06 S8477 Holt House V231027 150705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Salvation Army Address Holt House Headlands Drive Prestwich Manchester M25 9YF 0161 773 0220 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) Salvation Army Eva Ledson CRH Care Home 32 Category(ies) of OP Old Age 65 years and over : 32 Places registration, with number of places The Salvation Army F56 F06 S8477 Holt House V231027 150705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: The home is registered for a maximum of 32 service users, to include: up to 32 service users in the category of OP (Older People). The service should employ a suitably qualified and experienced manager, who is registered with the Commission for Social Care Inspection. Date of last inspection 03 December 2004 Brief Description of the Service: Holt House is a spacious, well-maintained property situated in a residential area of Prestwich. It provides personal care and support for up to 32 people over 65 years of age. The home is divided into three units, each with its own lounge and kitchen area. There is also a large communal lounge, dining room and conservatory. All but one room are single occupancy. Ramped access is provided to the front door of the home and ramps and a passenger lift are provided internally. There is a large garden area to the rear of the home which is well maintained. Level access is provided to a patio area where service users can sit and enjoy their surroundings. A conservatory, overlooking the garden is also provided. Parking for approximately 10 cars is provided within the grounds. Holt House is owned by the Salvation Army. The Salvation Army F56 F06 S8477 Holt House V231027 150705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over 5 hours. The Deputy Manager was in charge on the day of the inspection. Discussions about the standards of care took place with 4 residents, 4 visitors and 2 staff members. Some time was spent watching the manner in which staff supported residents, and taking part in the morning prayer meeting. Care plans, staff records and other paperwork relating to the care and safety of residents were also examined. What the service does well: What has improved since the last inspection? What they could do better: Although some good staff attitudes were observed, there was evidence to suggest that further training and checks are needed to make sure that all residents are treated with patience, sensitivity and respect at all times. The home also needs to make sure that residents who have a poor appetite are closely monitored and records kept to check that any actions needed are being carried out effectively. The Salvation Army F56 F06 S8477 Holt House V231027 150705 Stage 4.doc Version 1.40 Page 6 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. The Salvation Army F56 F06 S8477 Holt House V231027 150705 Stage 4.doc Version 1.40 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 The Salvation Army F56 F06 S8477 Holt House V231027 150705 Stage 4.doc Version 1.40 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) 3 Each person considering moving to Holt House has their needs assessed, and is given information about the home, before admission. EVIDENCE: Since the last inspection, the statement of purpose and Residents’ Handbook have been revised. Both documents are informative and the handbook is given to current and prospective residents. The admission process includes an initial assessment to ensure that the home can meet the individual’s needs, and a care plan is formulated from this basis. Assessments were seen to be in place for recently admitted residents. One newly admitted resident confirmed that she had made a positive choice in coming to Holt House and was happy with the standards. Holt House is a Christian home, and has a daily service that is open to all residents regardless of their religious background or beliefs. The Salvation Army F56 F06 S8477 Holt House V231027 150705 Stage 4.doc Version 1.40 Page 9 The Salvation Army F56 F06 S8477 Holt House V231027 150705 Stage 4.doc Version 1.40 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 and 8 Each resident’s personal, social and general health needs are reflected in their care plan and regularly reviewed. Improvements are needed to ensure that those at risk of poor nutrition are closely monitored. EVIDENCE: There have been improvements in the care plans since the last inspection. The care plans seen contained good information about individual routines and preferences. Areas covered included basic care needs, relationships and leisure, communication and general health. Although not reviewed every month, there was evidence of periodic reviews with changes noted in the care plan. The minutes of one review showed that the resident was enabled to participate and to make her views known. Each care plan included a moving and handling risk assessment and a nutritional risk assessment. However, one person had not been weighed regularly and another considered to be “high risk” nutritionally did not have clear instructions recorded for addressing the issue, or an intake chart completed. In order to ensure adequate nutritional intake, those at risk must be regularly weighed and closely monitored and reviewed. A dietician referral should be made if necessary. The home is also advised to complete pressure The Salvation Army F56 F06 S8477 Holt House V231027 150705 Stage 4.doc Version 1.40 Page 11 area risk assessments for residents so that prevention measures can be put in place for those at risk of developing pressure sores. This is an area highlighted at the last inspection. Discussions with residents and relatives confirmed that dental, optical, chiropody and GP services are accessed as necessary. The Salvation Army F56 F06 S8477 Holt House V231027 150705 Stage 4.doc Version 1.40 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 standard(s) 12 and 15 Residents’ religious needs and social preferences are reflected in a variety of activities and entertainment offered and enjoyed at the home. Residents feel their daily routines are flexible and are pleased with the choice and quality of meals. EVIDENCE: Residents said they have a choice in their daily routines, including what time they get up and go to bed, where to spend their time, and which activities to take part in. Observations made during the inspection confirmed this. Some residents were still having breakfast past 10am, and said that they are given choices about what they do during the day. The activities on the day included a well-attended prayer meeting in the morning and a violin recital in the afternoon. The prayer meeting was very much enjoyed by all who participated. It was lively and inclusive, combining readings and prayer with songs and reminiscence, and led enthusiastically by the Deputy Manager. It was also clear from residents’ conversations that they have a sense of care and concern for one another. There was a high level of satisfaction with meal provision. Residents consulted agreed that “the food is excellent” and said they are always given a choice. One added “but you can change your mind and they’ll get you something else if you don’t want what you chose”. The kitchen was well organised and the The Salvation Army F56 F06 S8477 Holt House V231027 150705 Stage 4.doc Version 1.40 Page 13 chef had a very good knowledge of residents’ likes, dislikes and dietary requirements. Breakfast is served in the small lounge / dining areas in the three units, with the main meals served in the large dining room. Residents may dine in their own rooms if they wish. The Salvation Army F56 F06 S8477 Holt House V231027 150705 Stage 4.doc Version 1.40 Page 14 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 Residents, their relatives and visitors feel able to air their views and feel any issues they raise will be promptly addressed. There was evidence of the need to ensure that all staff are sensitive and have good, patient attitudes in their interactions with residents at all times. EVIDENCE: The home has a clear, written complaints procedure that is included in the statement of purpose and the residents’ handbook and is also displayed in the entrance to the home. The manager continues to record minor complaints, their investigation and outcome. From observations and discussions, some staff members were sensitive and approachable, which helped residents to feel comfortable in raising issues informally. However, a situation was overheard where a staff member sounded impatient and sharp with a resident who had changed her mind about having lunch. The carer’s attitude was not challenged by other carers who were within hearing, a factor that highlights a serious concern. This was brought to the notice of the Deputy Manager and staff member during the inspection, and staff must be reminded to adhere to the principles of respect in their dealings with residents at all times. Attitudes and care delivery must be observed and monitored regularly to ensure good standards are consistently upheld. This need is further highlighted by a comment from one resident who said “The staff are good with you, but they have to be sharp with some people here who can be awkward.” Clearly residents with a right to a caring service should not be perceived as ‘awkward’ a perception suggested by this resident’s remarks through her observations of practice. The Salvation Army F56 F06 S8477 Holt House V231027 150705 Stage 4.doc Version 1.40 Page 15 The Salvation Army F56 F06 S8477 Holt House V231027 150705 Stage 4.doc Version 1.40 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) These key standards were not assessed at this inspection. EVIDENCE: There were no hazards noted on the day of the inspection, and the home was very clean and well maintained. The home will be assessed against these key standards at the next inspection. It was noted that residents made very positive comments about the environment. The Salvation Army F56 F06 S8477 Holt House V231027 150705 Stage 4.doc Version 1.40 Page 17 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) 27 Staff are employed in sufficient numbers, and are provided with training to carry out their roles. EVIDENCE: The staff rota shows that there are 5 carers on duty in the morning, with the duty manager and senior, and 4 in the afternoon and evening. At night, one senior and 2 carers are on duty. The responsibility for catering and domestic duties was contracted out and sufficient ancillary hours provided. Staff members consulted said that they are able to carry out their roles effectively within these staffing levels. They also confirmed that they receive training in mandatory topics such as moving and handling and first aid and there was evidence of this in the staff files seen. Some have attended dementia care training and found this useful. The Salvation Army F56 F06 S8477 Holt House V231027 150705 Stage 4.doc Version 1.40 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 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) These key standards were not assessed at this inspection. EVIDENCE: The manager was absent from the home on the day of the inspection. The home will be assessed against these standards at the next inspection. The Salvation Army F56 F06 S8477 Holt House V231027 150705 Stage 4.doc Version 1.40 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x x x x x x x x x x The Salvation Army F56 F06 S8477 Holt House V231027 150705 Stage 4.doc Version 1.40 Page 20 No 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 8 Regulation Requirement Timescale for action 12 September 2005 2. 16 13, 14, 15 In order to ensure adequate nutritional intake, those at risk must be regularly weighed and closely monitored and reviewed. A dietician referral should be made if necessary. The home must also complete pressure area risk assessments for residents so that prevention measures can be put in place for those at risk of developing pressure sores. 12, 13, 18 Staff must be reminded to adhere to the principles of respect in their dealings with residents at all times. Attitudes and care delivery must be observed and monitored regularly to ensure good standards are consistently upheld. 14 July 2005 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 F56 F06 S8477 Holt House V231027 150705 Stage 4.doc Version 1.40 Page 21 The Salvation Army 1. The Salvation Army F56 F06 S8477 Holt House V231027 150705 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Turton Suite, Paragon Business Park Chorley New Road Horwich Bolton BL6 6HG 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. 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