Inspection on 13/07/05 for The Hollies

This inspection was carried out on 13th July 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Hollies 05/11/08

The Hollies 16/11/06

The Hollies 27/01/06

The Hollies 20/01/05

The Hollies 06/07/04

Similar services:

Abbey The

Snydale Care Home

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE The Hollies 27 Church Lane Garforth Leeds LS25 1NW Lead Inspector Paul Newman Unannounced 13 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 Hollies 20050713 The Hollies UN Stage 4 S1462 V236934 J52.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Hollies Address 27 Church Lane Leeds LS25 1NW 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) 0113 2871808 0113 2875591 Garforth Residential Homes Ltd Mrs Nicola Berry Care Home 28 Category(ies) of Old age (28) registration, with number of places The Hollies 20050713 The Hollies UN Stage 4 S1462 V236934 J52.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 20/01/05 Brief Description of the Service: The Hollies is a care home owned by Garforth Residential Homes Limited and is situated in Garforth, a suberb of Leeds. The home provides personal care and support to twenty-eight older people. Nursing care is not provided but the home is supported by local healthcare services. The property is an Edwardian building, with a recent extension and all rooms are single occupancy. The grounds include car parking facilities, and shrubs to the perimeters of the grounds. The company’s sister home, St. Armand’s Court is situated across the courtyard. The home has a passenger lift and communal facilities include a conservatory, three lounges and a dining room. The Hollies 20050713 The Hollies UN Stage 4 S1462 V236934 J52.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Over an inspection year from April until March, regulated care homes have a minimum of two inspections a year; these may be announced or unannounced. The last inspection was unannounced and took place on the 20 January 2004. There have been no further inspections until this unannounced visit. The people who live in the home prefer the term resident, and this is the term that will be used throughout this report. This was this inspector’s first visit to the home and the purpose of this inspection was to gain an overview of the care, services and facilities provided and also to assess progress in the way the home is dealing with issues that were raised in the last inspection report. During the inspection records were looked at, some parts of the home were seen, such as bedrooms, lounges and bathrooms; care staff were seen carrying out their work; conversations were held with the manager, four members of staff, two relatives and four residents. Survey cards were left at the home for residents, relatives or visitors to complete and return to the Commission for Social Care Inspection (CSCI). These cards provide an opportunity for people to share their views of the service with the CSCI. Comments received in this way will be shared with the provider without revealing the identity of those who replied. The inspection started at 9.15 and lasted for five hours, in addition time was spent preparing for the inspection and checking the survey responses that were received. What the service does well: What has improved since the last inspection? The home continues to provide good standards of care that are appreciated by residents and relatives. Some further redecoration has been done. The ongoing training programme for staff makes sure that they are up to date with safe working practices and their knowledge and skills further developed. Some minor amendments have been made to the statement of purpose that reflect new qualifications that staff have achieved. The home has conducted further The Hollies 20050713 The Hollies UN Stage 4 S1462 V236934 J52.doc Version 1.40 Page 6 satisfaction surveys for residents, relatives and staff, the results of which have been formulated into reports that include an action plan for improvement. 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. The Hollies 20050713 The Hollies UN Stage 4 S1462 V236934 J52.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 Hollies 20050713 The Hollies UN Stage 4 S1462 V236934 J52.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) 1, 3, 4 and 5 The written information about the home that is given to people thinking about living there is accurate and up to date. The admission process is good and includes introductory visits. Residents’ needs are properly assessed and well informed and knowledgeable staff meet these needs. EVIDENCE: The manager has up dated the statement of purpose to reflect more qualifications that the staff have achieved. The written information accurately reflects the care and services provided at the home. Three care plans were checked and all had detailed pre-admission assessments completed that formed the foundation of the care plan. There was evidence of the involvement of the resident and/or relative in the assessment and ongoing review of the care plan. A relative said that she felt the home kept her up to date with the care of her mother. She had looked at other homes before deciding on the Hollies and it was the friendly welcoming atmosphere that had been a major factor in the decision. Some residents said that that they had visited the home before moving in and where this had not been possible a relative had done this on their behalf. Three staff spoken with all had a good knowledge of the residents care needs and personal preferences. Systems of The Hollies 20050713 The Hollies UN Stage 4 S1462 V236934 J52.doc Version 1.40 Page 9 communication between the staff, like shift handovers are well established and make sure that important information is passed on a daily basis. The Hollies 20050713 The Hollies UN Stage 4 S1462 V236934 J52.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, 8, 9 and10. Care plans provide staff with clear, and up to date information and guidance to follow. Health care needs are identified and monitored with good support from local health care services. Medication procedures and practices are safe. Staff are aware of residents’ needs and treat residents with dignity and respect. EVIDENCE: Three care plans were seen. These provided staff with clear information about the care needs of individual residents and guidance about the way to deliver the care. The plans are evaluated each month and changes are recorded. Risk assessments are also included and these are also subject to review and are up to date. Liaison with doctors, nurses, dentists, the optician and dentists was recorded. Medication policies and procedures were discussed and practice observed. This was safe and the recording of the administration of medicine was error free. Further training has been arranged for staff. Care practices that were observed showed staff giving sensitive care that made sure that the residents were treated with respect and dignity. Residents said that staff are friendly and helpful and respect their privacy like knocking on doors before entering. The Hollies 20050713 The Hollies UN Stage 4 S1462 V236934 J52.doc Version 1.40 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 standard(s) 12, 13, 14 and 15. Residents are encouraged to make their own decisions about their lifestyle. Family, friends and visitors are welcomed at the home. Social and leisure activities are offered that people are happy with. Good wholesome food is provided and residents’ personal likes and dislikes are known and honoured. EVIDENCE: The results of the home’s own satisfaction survey that was completed by twelve of the residents showed that they felt there were sufficient activities offered and that they were able to follow their religion and see visitors at any time and in private. They were able to get up and go to bed when they wished, free to spend time privately in their rooms and were happy with the external services offered by the hairdresser, optician, dentist and chiropodist. During the inspection the residents spoken with reinforced these views. A visitor said that she felt welcomed and comfortable in the home and was able to visit at any time. One independent resident goes to check his home in another part of Leeds most weeks and has coffee with his neighbours. The menus have recently been changed following discussion with the residents both individually and at a residents’ meeting. Residents spoken with said that the food was good, there was always plenty of it and that their likes and The Hollies 20050713 The Hollies UN Stage 4 S1462 V236934 J52.doc Version 1.40 Page 12 dislikes were known and kept to. There are regular snacks and drinks provided throughout the day. The meal served was well presented, hot and was enjoyed by all. The Hollies 20050713 The Hollies UN Stage 4 S1462 V236934 J52.doc Version 1.40 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 Residents and relatives understand that they can raise concerns and feel confident in doing this. They feel staff listen and respond quickly to put things right. EVIDENCE: The complaints procedure is in the service user guide that is given to all service users. It is also posted on notice boards around the home. The residents spoken with said that they felt comfortable in raising concerns with staff and that when they did, staff acted quickly to put things right. A relative was aware of the complaints procedure, confident in approaching staff but had never had to raise anything. The Hollies 20050713 The Hollies UN Stage 4 S1462 V236934 J52.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26 The home is safe and well maintained and offers comfortable communal lounge areas. Bedrooms suit personal needs, can be personalised with your own possessions and made private. The home has aids that make things like bathing and toileting easier. EVIDENCE: All the communal areas, the kitchen, laundry and some bedrooms were seen. No health and safety hazards were noted and staff were seen doing their work properly dressed and equipped, and their practices make sure the home is clean, free from unpleasant smells and hygienic. Some redecoration has been carried out but the owners have not been able to do all of the work that was noted in the last inspection report and explained that they are in dispute with the Local Authority about money owed. This has gone on so long they are taking the matter to court. The owners like to keep the home in good condition and when the matter is resolved, will be able to do the things that have been agreed with the Commission. If not, new agreements will be made. Even so, it is a very acceptable place to live. The Hollies 20050713 The Hollies UN Stage 4 S1462 V236934 J52.doc Version 1.40 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 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, 28 and 30. The staff are experienced, well trained and know what they are doing. They have good relationships with the residents and care for them well. EVIDENCE: Four members of staff were spoken with during the inspection. They are well organised and there are well established systems of shift handovers, staff meetings that mean information about the residents is up to date. The staff knew each of the residents well and the relationships were good with a lot of warmth and humour. The residents said that staff listen to their views, are friendly, and treat them well. They felt well cared for. The Company has a training coordinator and from the records seen and what the staff said, this makes sure that the staffs’ training is up to date and in line with the National Minimum Standards that are set. This is commendable and should give people confidence that staff know what they are doing. The staff are committed to training because they know it helps them and they said it makes them feel more confident in their work. The Hollies 20050713 The Hollies UN Stage 4 S1462 V236934 J52.doc Version 1.40 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 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) 31, 32, 33, 37 and 38 The home is well managed and the interests of the residents are the main concern of the manager and staff. Record keeping, safety checks and systems of communication make sure that the home is a safe place to live. EVIDENCE: The manager is appropriately qualified, is experienced and the staff and residents like the way she manages. She is enrolling for a qualification – The Certificate in Dementia Care – as part of her personal development and preparation for possible future changes in the registration category of the home. She is a ‘hands on manager, knows what is going on and checks things personally. All of the residents and staff spoken with said that the manager was very approachable and listened to their views. There are other more formal ways of checking the standards of care like satisfaction surveys the results of which are collated into a report that is available in the hallway for relatives, residents and visitors. The record keeping in the home is good. The information about residents is clear and up to date including risk assessments, The Hollies 20050713 The Hollies UN Stage 4 S1462 V236934 J52.doc Version 1.40 Page 17 and regular safety checks are made on equipment and are recorded to make sure the building is safe. The atmosphere in the home is warm and friendly and the residents and relative said that they like this. Residents said that staff responded to the emergency call system very quickly and this made them feel safe. The Hollies 20050713 The Hollies UN Stage 4 S1462 V236934 J52.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 3 3 N/A 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 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 x 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 x x x 3 3 The Hollies 20050713 The Hollies UN Stage 4 S1462 V236934 J52.doc Version 1.40 Page 19 yes 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 OP19 Regulation 13 Requirement Timescale for action 31.03.06 2. 3. OP25 OP28 23 18 The manager must ensure the home is in good decorative order and corridor carpets replaced. Outstanding from report of 20/01/05 All central heating radiators must 31/03/06 be low surface temperature or fitted with guards. 50 of care staff must achieve 31/12/05 NVQ level 2 by the end of 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. 1. Refer to Standard OP31 Good Practice Recommendations The manager is commended and encouraged to complete qualifications in the care of people with dementia as part of her personal development and preparation for the possibility of changes in the registration category of the home. The Hollies 20050713 The Hollies UN Stage 4 S1462 V236934 J52.doc Version 1.40 Page 20 Commission for Social Care Inspection Aire House Town Street Rodley LS25 1NW 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 The Hollies 20050713 The Hollies UN Stage 4 S1462 V236934 J52.doc Version 1.40 Page 21 - 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!