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Inspection on 30/10/08 for Holywell Dene Care Home

Also see our care home review for Holywell Dene Care Home for more information

This inspection was carried out on 30th October 2008.

CSCI found this care home to be providing an Good service.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

There is a good management system in place and the manager workers hard to run the home in a way which protects and support the people living there. There is a homely and pleasant atmosphere in the home which is comfortable and well decorated, the staff work hard to make sure that it is clean and tidy. Residents were very complementary about both the care staff and the ancillary staff, one said they are always "very pleasant and helpful" and another said "the cleaners keep the home spotless". The home provides good quality, nutritious food which offers choice and variety for the residents. The food being served was tasty and the people living in the home were complementary about both the food and the staff who they said were always willing to try to accommodate their needs.

What has improved since the last inspection?

Staffing levels have improved since the last inspection. The staff rota shows that although there are occasionally periods when shortages do occur due to combinations of holiday and short notice sickness these are generally covered by the homes own staff. Residents are supported to make choices in the way they live and they are given good information about the options, for example the menus or the social activities available. Fire safety training programmes are up to date and the manager schedules further training to make sure that updates are carried out. There is a strategy in place to make sure that all staff attend statutory training. There have been improvements made to the way that medicines are managed and recorded.

What the care home could do better:

No requirements or recommendations were made as a result of this inspection. The manager and the company have a quality assurance strategy to look at the way the service could make improvements and these are implemented as necessary.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Holywell Dene Care Home Holywell Dene Holywell Whitley Bay Tyne & Wear NE25 0LB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Suzanne McKean     Date: 3 0 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Holywell Dene Care Home Holywell Dene Holywell Whitley Bay Tyne & Wear NE25 0LB 01912374424 01912374420 holywelldene@highfield-care.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Cheryl Opal Glenton Type of registration: Number of places registered: Southern Cross Care Homes Limited care home 50 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Holywell Dene Care Home was purpose built in 1993, to provide residential care for up to 50 people over the age of 65years.The building is on a sloping site in the village of Holywell. The main entrance at the front of the building gives access to the middle floor and it is a three story building. There are pleasant views of Holywell Dene from the rear of the building and There is a large patio to the side of the building there is a patio area for residents use. A passenger lift provides access to all floors. Parking is available to the rear of the building and ramps at the front door provide access for people with mobility difficulties. The home provides information about its service in the statement of purpose and service user guide. This and the homes last inspection report are available in the front entrance. The home charges fees ranging between £419.08 and £491.00 pounds depending upon the individual needs and requirements of Care Homes for Older People Page 4 of 26 0 Over 65 50 Brief description of the care home individual residents. As the home provides nursing care the free nursing care element of the funding is provided in addition to the costs charged to the resident. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: Summary - This is an overview of what the inspector found during the inspection. How the inspection was carried out Before the visit we looked at:- Information we have received since the last visit on 1st November 2007. How the service dealt with any complaints or concerns since the last visit. Any changes to how the home is run. The providers view of how well they care for people. The views of people who use the service and their relatives, staff and other visiting professionals. An unannounced visit was made on 30th October 2008 and was completed over seven Care Homes for Older People Page 6 of 26 hours. During the visit we: Talked with people who use the service, relatives, staff the manager and visitors. Looked at information about the people who use the service and how well their needs are met. Looked at other records which must be kept. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the building to make sure it was clean, safe and comfortable. Checked what improvements had been made since the last visit. We told the manager what we found. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care plans contain the necessary information to show that assessments are carried out before any resident is admitted to the home. The documentation is detailed and contain all of the necessary information for the staff to make a judgment about if a place should be offered to the resident. Residents had been given a copy of the statement of purpose and service user guide to tell them of the homes facilities and enable an educated choice to move in. These assessments then form the basis of the care planning process for the records. Residents said that they were given the opportunity to visit the home before they decided to move but the majority had relied upon their family to choose for them. One however visited the home and had lunch with the residents, she said that she was pleased that she had done this as it made her more comfortable about coming into the home. Care Homes for Older People Page 10 of 26 Evidence: Good assessments carried out before offering a place make sure that none is admitted who cannot be cared for safely. Residents can then be confident that their needs will be met. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home have their health and personal care needs met in a planned way delivered in a respectful way and the care plan shows how this is being achieved. Evidence: All of the residents have individual records which include an assessment and a plan of care. These assessments are carried out once the resident is admitted to the home and are then added to over the period of their stay. The assessments include all of the area of possible need including their activities of daily living and their health care needs. A plan is then devised to show the staff how to support the resident in their day to day lives and to maintain their health and wellbeing. Necessary risk assessments are completed for a selection of areas including falls, nutrition and deterioration in the residents skin condition when they are unable to change their position themselves. These were detailed up to date and easy for staff to follow. Residents are supported to access NHS services and facilities as and when they need to. The care plans showed that specialist advisors are used for individual Care Homes for Older People Page 12 of 26 Evidence: residents. The home liaises with the General Practitioners who provide care to the residents. The residents records show that the personal and health care needs of the residents are being met. Staff have ongoing training in the completion of the documentation. The staff spoken to were knowledgeable about the contents of the care plans. They were making entries throughout the day and referring to them when professional advisors visited to see specific residents. Although the residents were aware of the care plans they had not been fully involved in them being written, it would be helpful for them if they could be involved and the involvement recorded more fully. Residents were dressed for the activities they were undertaking and looked smart and tidy. A number of residents were positive about the care being given. An example of this is I like living here and there is no place like home but its as nice as it could be here without being at home. Care is given in a discreet manner taking into account the individual residents previous lifestyles and the way they want to spend their time. Staff are knowledgeable about residents preferences and needs. They were seen being kind and polite with cheerful banter taking place throughout the day. Staff spoke to residents always explaining what was about to happen and what they were going to do so that residents knew what to expect when being helped to move around the home. This was particularly evident in the care staff who were flexible in how they gave the care according to how the resident was feeling. All residents have individual rooms that they can use if they need to discuss issues with family, friends or staff so that their privacy is safeguarded. Medication is well managed in the home to make sure that the residents receive their medication as proscribed. The medication is disposed of safely when no longer needed. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported to spend their leisure time in a variety of ways and maintain contact with their families and the local community. The food provided is good and the meal times are a pleasant experience for the people living in the home. Evidence: The home employs an activities co-ordinator and she there evidence in the home that she is working with the residents to give them opportunities to take part in activities according to their choices and interests. The staff were knowledgeable about the social and recreational care needs of the service users. This was shown in the care plans and confirmed by residents. There are regular activities for the service users and evidence of Halloween celebration being promoted. One person living in the home described some of the opportunities they had been offered and although they felt that this was enough they did not always want to take part. The home has access to two minibuses depending upon the needs of the residents who are to use them. This gives the opportunity to go to both local shops and attractions Care Homes for Older People Page 14 of 26 Evidence: further away from the home. The residents are supported to continue their religious practices. Service users confirmed that they are free to join in social activities if they wish and that they are not made to join in activities if they do not want to. There is a four-week rotational menu in operation in the home. Past menus indicate that the home provides wholesome and nutritious meals for the service users thus promoting good health. Service users were very complimentary about the food. They confirmed that they are provided with good choice and that there is always plenty of food for them. The residents are encouraged to maintain their independence at meal times by specialist equipment to assist them for example large handled cutlery and place guards. The lunch time was observed, it was well organised and the dining rooms were well presented and pleasant places for the people living in the home to enjoy their meals. Throughout the meal staff were courteous and continuously asked the residents about their choices and offering second helpings. The meal served was Steak and kidney pie/pudding, mashed potatoes, roast potatoes, sprouts, carrots, with gravy. The alternative was a chicken salad. The pudding was creme caramel or ice cream or fruit. All of the choices were available to all and a number of them expressed how much they enjoyed them. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good policies and procedures in place to that make sure complaints and safeguarding issues can be dealt with efficiently and that residents are safeguarded from abuse. Evidence: There are good policies and procedures available setting out how to make a complaint. The procedure is displayed in the home and the staff knew how to deal with any complaints that are raised with them. The complaint recorded since the last inspection was well managed. Residents and relatives spoken to were aware of the complaints policy and said that they would know who to speak to if they had any concerns. The residents spoken to feel that any concerns they have are dealt with through the resident meetings, the open door policy and the processes used to find out the views and opinions. There are policies and procedures in place for Adult Protection. The staff have received training that is ongoing. This includes how to recognise abuse and what to do if they suspect that abuse is taking place. Staff interviewed understood these principles and could describe the way they would act in response to any concerns they had. The home has a policy for whistle blowing and the staff are made aware of this at an early stage in their employment through the induction process. Care Homes for Older People Page 16 of 26 Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents have a clean and homely place to live, which is safe and well maintained, an ongoing decoration and improvement programme makes sure it does not deteriorate. Evidence: Holywell Dene is a purpose built care home situated in a small village. The home offers accommodation that is clean and well maintained, and has design features to help people of this client group, such as a lift to all floors and ramp access to the home. This promotes their dignity, comfort and welfare of people living in the home. The residents are encouraged to furnish their rooms with personal items, making it pleasant and familiar environment for them. There are a variety of shapes and sizes of bedroom available. Bedrooms seen were particularly well personalised and show the diverse lifestyles of the residents living in the home. The communal and bedroom areas are nicely decorated and were clean and well maintained. Access into and within the home is good and meets the needs of those service users who have mobility difficulties or have use of walking aids such Zimmer frames or wheelchairs. There are specialist bathing facilities to promote independent use by those who are capable of doing so. All the bedrooms and toilets have suitable lock on Care Homes for Older People Page 18 of 26 Evidence: the doors to ensure privacy. This provides the opportunity for service users to remain independent and to enjoy good levels of privacy. There are sufficient numbers of communal areas for service users to choose from. These include a range of lounges, dining rooms, and communal spaces that people living in the home can use. Window restrictors have been fixed to all windows and all radiators have suitable coverings, which ensure security and safety for the service users. Checks of hot water are carried out by the home and these show that hot water did not exceed 43°c. thus protecting the service from accidental injuries. The home has written policies and procedures relating to safe handling of hazardous materials for staff to follow. The staff confirmed they have had training in health and safety, infection control and food hygiene. The laundry machines have facilities for sluicing and washing foul linen at very high temperature to avoid the spread of infection. The home was noted to be clean and free from offensive odours. Staff were following appropriate control of infection practices to reduce the risk of spreading infection in the home. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are skilled, well trained, and competent staff employed in sufficient numbers to make sure that they can provide good care to the residents. Evidence: The home maintains good staffing levels, which ensure that service care needs are met. Rotas showed staffing levels being consistently maintained. The home has a long established staff team who have been provided with the necessary training to equip them for their job. The majority of the staff have attained NVQ qualifications. Staff spoke of the good training they have received and the benefits to them and the service users. Examination of the staff training record showed there is up to date training all of the areas necessary for the staff to be safe in their roles. Any gaps are identified and plans put in place for individual staff to be updated as necessary. There is a good induction procedure for new staff into the workplace. There is good documentary evidence of induction training provided for all new staff. This makes sure that the registered persons can satisfy themselves that staff have received proper induction and have been assessed as competent to undertake their duties unsupervised. Care Homes for Older People Page 20 of 26 Evidence: The records of the most recently appointed staff were examined. These contained evidence of good recruitment procedures being followed. This ensures that the service users are protected from possible abuse from people who would be deemed as not suitable to work with vulnerable people. Suitable references have been obtained and checks such enhanced Criminal Records Bureau and identification checks have been carried out and were all in order. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The registered manager and her team have effective ways to manage the home in the best interest of the people living there. This protects them and supports them to live fulfilled lives. Evidence: The Registered Manager, has the appropriate qualifications and experience to successfully manage the home. She has experience in looking after older people. She contributes toward the general feeling of well being in the home. Staff said they felt well supported and were able to work toward qualifications. Supervision is offered to the staff so that they have an opportunity of one to one discussion with management. The way that supervision was being offered was discussed. The programme is generally up to date as there is a programme in place. The manager is responsible for making sure that safe working practices such as testing Care Homes for Older People Page 22 of 26 Evidence: water temperatures and fire safety are carried out although the tasks are carried out by the handyman. She is also responsible for auditing all systems and procedures through the home to ensure safety of residents, visitors and staff. The statutory requirement for the home to have an internal monitoring system (Regulation 26) to look at the quality of the service being offered is met by the regional manager. The residents are supported to be involved in the decisions that are made about the way the home is run and choices that are made. An example of this was the resident meeting that was carried out on the day of the visit, the attendees were very well involved and discussed a number of subjects that they were involved in planning eg social activities and the menus. This meeting was attended by the activities coordinator and one of the kitchen staff as well as care staff and the manager. The administrator took notes so that residents not attending could be made aware of the issues discussed. The accident recording in the home is robust. Case tracking showed that entries in the accident book were reflected in the daily record within individual care files. Accidents are monitored and analysed so that risks can be identified. Safety is promoted for residents by using these systems effectively and by having a staff group that is trained in fire safety, moving and assisting, infection control and food hygiene. Staff meetings are held regularly and staff said that they found them useful, giving the chance to hear what is planned in the home. They also have the chance to raise any concerns they have. Residents are supported to remain as independent in management of their personal finances and are assisted when they are no longer able to do this. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 It is recommended that the home look at ways to further involve the residents in the writing and review of their care plans. Care Homes for Older People Page 25 of 26 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 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!