Inspection on 20/12/05 for Holyrood House

This inspection was carried out on 20th December 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

Holyrood House 22/01/09

Holyrood House 22/11/07

Holyrood House 21/06/07

Holyrood House 06/07/06

Holyrood House 17/08/05

Holyrood House 10/03/05

Holyrood House 13/01/05

Holyrood House 20/02/04

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 Holyrood House 46 Green Lane Ostend Burnham On Crouch, Maldon Essex CM0 8PU Lead Inspector Brian Bailey Unannounced Inspection 11.45 20 & 29 December 2005 th th 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 Holyrood House DS0000017852.V270413.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. Holyrood House DS0000017852.V270413.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Holyrood House Address 46 Green Lane Ostend Burnham On Crouch, Maldon Essex CM0 8PU 01621 784759 01621 784856 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) Mr Peter Walters Mrs Melanie Walters Mrs Melanie Walters Care Home 3 Category(ies) of Old age, not falling within any other category registration, with number (3) of places Holyrood House DS0000017852.V270413.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th August 2005 Brief Description of the Service: Holyrood House is a detached property that was first registered as a private care home for three older people in 1994. The proprietors are Peter and Melanie Walters, who is also the registered manager. This home is situated on the outskirts of Burnham on Crouch but is not within walking distance of the towns facilities. Holyrood House caters for three older people with low to medium dependency levels in a homely environment, which they share with the proprietors. Being a family home, residents are treated as family friends and receive consistent day-to-day care and involvement with the proprietors and a small team of care staff. Residents are encouraged to treat the home as their own and to be involved in the daily routines of running a house. Residents private accommodation is in single bedrooms on the ground floor. Access to the front of building and the rear garden via the new patio doors is good although wheelchair users would find it difficult to access the garden. Adequate car parking facilities are available at the side of the property. Holyrood House DS0000017852.V270413.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on 20th December at 11.45am and 29th December 2005 at 10.00am. The manager and a staff member were on duty and three residents were living at the home. The inspector spent the day meeting the registered providers and manager, staff and three residents. Records, policies and procedures were checked. A resident gave their views about the home and the service provided, which is included in the report. Completed CSCI questionnaires were returned that provided a positive view of the home. What the service does well: What has improved since the last inspection? The dining room has been upgraded with new patio doors and windows fitted and floor covering, which have improved its appearance. With the addition of some new armchairs, the room is now an ideal place for residents to entertain visitors as well as continuing to be used as a dining room. Holyrood House DS0000017852.V270413.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. Holyrood House DS0000017852.V270413.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 Holyrood House DS0000017852.V270413.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): 4. Residents benefit from being able to visit and see for themselves the facilities available and to determine whether the home will meet their needs. EVIDENCE: All prospective residents are encouraged to visit the home to view the accommodation and to see the facilities and to meet staff and the other residents. This is stated in the home’s Statement of Purpose. In practice, it is generally relatives that visit on behalf of their relatives to assess the home although in some cases, people are already aware of the home and have waited for a vacancy to occur. This was the situation concerning the most recent admission. Holyrood House DS0000017852.V270413.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 8 and 11. Residents benefit from a staff team that ensures appropriate care and attention is given to meeting their health care needs. Further training on medication will help staff to minimise any potential risks to residents. EVIDENCE: Records showed that the home was enabling residents to access health care professionals as required. All three were registered with a GP. A chiropodist visits the home twice yearly and provides a comprehensive service that includes a foot massage and a qualified person attends every six to eight weeks to cut toenails. A hairdresser visits every two weeks and a district nurse attends when required but was not required at the time of the inspection. None of the residents have pressure sores although one resident is at risk owing to preferring to remain in bed for much of the time each day. A special mattress has been provided. A local optician attends the home periodically unless there is an emergency. Records showed the manager had obtained the wishes of residents concerning terminal care and arrangements to be made after death. An example was Holyrood House DS0000017852.V270413.R01.S.doc Version 5.0 Page 10 given by the manager that demonstrated appropriate care and attention had been given to a resident. Evidence was not available to show that staff responsible for the administration of medication had received appropriate training to assess their competency, however, the manager had contacted the supplying pharmacist to arrange further training. Holyrood House DS0000017852.V270413.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13. Residents benefit from being able to receive visitors and friends at any time in a homely environment. EVIDENCE: The recent dining room adaptations have made the room an ideal place for visitors to meet their relatives with some degree of privacy. There are no restrictions imposed on visitors although residents are able to choose who they wish to see. The home encourages visitors who are free to come and go as they please. A resident spoke of having received their visitors and of how they had been made to feel at home. None of the residents are able to access the community independently although none have expressed a wish to go out. Holyrood House DS0000017852.V270413.R01.S.doc Version 5.0 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18. The home has appropriate arrangements in place to protect residents from abuse. EVIDENCE: The home has a policy and procedure on the protection of vulnerable adults from abuse and a whistle blowing policy. Since the last inspection, the owners/manager attended a course in October 2005 and have passed the information onto the staff. Two staff are due to attend a training course in March 2006. Holyrood House DS0000017852.V270413.R01.S.doc Version 5.0 Page 13 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 and 26. The standard of the environment within this home is good, providing residents with an attractive and homely place to live, which has been enhanced with the dining room improvements. The patio area has steps leading to the garden, which could present a trip hazard to residents. EVIDENCE: Holyrood House is a large detached property that blends in well with the neighbouring properties. Residents’ private accommodation consists of three single bedrooms, each with en-suite WC facilities, which are on the ground floor. All bedrooms were bright and cheerful and had been personalised. Communal rooms consist of a lounge and dining room that overlooks the rear garden. The dining room has been upgraded with new patio doors and windows and new floor covering and some new armchairs. The front door has a step that would present a difficulty for wheelchair users. The patio area has steps leading to the garden, which could present a trip hazard to residents. Holyrood House DS0000017852.V270413.R01.S.doc Version 5.0 Page 14 Unrestricted car parking is available at the side of the property. All rooms were clean and tidy including the kitchen, which was well equipped. Residents are free to access all communal areas within the home although two residents prefer to stay in their bedrooms. Holyrood House DS0000017852.V270413.R01.S.doc Version 5.0 Page 15 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): 29. Residents benefit from being supported by a small team of experienced and motivated staff, but recruitment procedures must include obtaining CRB disclosure checks for staff before appointments are made. EVIDENCE: This is a small home managed and run by the registered person/manager and two members of staff. The need for the recruitment of new staff is therefore limited and there has been no change to the staffing structure since the last inspection. The manager was aware of the need to obtain CRB disclosure checks before staff are employed but had only just applied for checks to be done. Holyrood House DS0000017852.V270413.R01.S.doc Version 5.0 Page 16 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): 35 and 38. Systems for looking after residents’ money for safekeeping are in place. Any delays in ensuring all equipment and systems are serviced at the specified intervals is a potential hazard to residents. EVIDENCE: Only small sums of residents’ money looked after for safe keeping are held at the home, records were available that showed that all income and expenditure is recorded and these were accurate and up to date. All expenditure reflected the items considered to be extra to the fees such as toiletries, chiropody and hairdressing. Since the last inspection, as recommended the manager had managed to obtain a visit by a fire prevention officer who attended and checked the procedures during September 2005. A few recommendations were made and Holyrood House DS0000017852.V270413.R01.S.doc Version 5.0 Page 17 the manager was aiming for these to be rectified by the end of January 2006. Food hygiene training is booked for 26/1/06 and portable electrical tests are also to be carried out in January. A gas service was undertaken on 28/12/05 and was due to return on 4/1/06, as there were continued problems with the heating. The temperature in several rooms of the house was lower than would be expected, although residents had been made comfortable and warm. All staff have moving and handling training. Hot water outlets are protected. Holyrood House DS0000017852.V270413.R01.S.doc Version 5.0 Page 18 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 X X X 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 X 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 X 28 X 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X 2 Holyrood House DS0000017852.V270413.R01.S.doc Version 5.0 Page 19 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 OP9 Regulation 13 Requirement Staff that administer medication must receive training that includes an assessment of their competency, preferably by an external assessor. (Timescale 1/12/05 not met) The registered person must ensure that all staff are provided with training on the protection of vulnerable adults from abuse. (Timescale of 1/12/06 not met) The patio area must be made safe for residents to use should they wish to go out into the garden. CRB disclosure checks must be obtained for all staff and for new staff before they commence working at the home. Timescale for action 01/03/06 2. OP18 13 01/04/05 3. OP20 23 01/01/06 4 OP18 13 01/02/06 4 OP38 23 Work required to improve the 01/03/06 fire precautions by the fire officer must be carried out. Holyrood House DS0000017852.V270413.R01.S.doc Version 5.0 Page 20 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. Refer to Standard OP38 Good Practice Recommendations That all documentation relating to Health & Safety at the home is kept in a file for easy access. Holyrood House DS0000017852.V270413.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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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