Inspection on 14/02/07 for The Hollies

This inspection was carried out on 14th February 2007.

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

The Hollies 10/01/06

The Hollies 22/09/05

The Hollies 03/02/05

The Hollies 17/09/04

The Hollies 11/03/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Stallcombe House

Belma

Hunters Care Centre

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

CARE HOMES FOR OLDER PEOPLE The Hollies 1 Tremodrett Road Roche St Austell Cornwall PL26 8JA Lead Inspector Alan Pitts Key Unannounced Inspection 14th February 2007 09:30 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 The Hollies DS0000009041.V325955.R01.S.doc Version 5.2 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. The Hollies DS0000009041.V325955.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Hollies Address 1 Tremodrett Road Roche St Austell Cornwall PL26 8JA 01726 890247 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 Dye Mrs Maryel Dye Mrs Linda Jones Care Home 20 Category(ies) of Dementia - over 65 years of age (10), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (10), Old age, not falling within any other category (20) The Hollies DS0000009041.V325955.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. Service users to include up to 20 adults of old age (OP) Service users to include up to 10 adults aged over 65 with dementia (DE{E}) Service users to include up to 10 adults aged over 65 with a mental disorder (MD{E}) Service users to include one named person out of age category Total number of service users not to exceed a maximum of 20 Date of last inspection 10th January 2006 Brief Description of the Service: The Hollies is a period property situated in the heart of the village of Roche. The home provides residential care for up to 20 elderly people, including up to ten that have dementia (DE (E) or a Mental Disorder (MD (E). There is a garden and car parking space to the front of the home, with a lawn and patio easily accessed by service users. A conservatory has been built onto the front of the home, which also provides staff with a new office. Accommodation is provided on two floors accessed by a stair lift. There is a large lounge for non-smokers with an adjacent smaller lounge for those wishing to smoke. Meals are prepared in a spacious kitchen and served in the dining room, this adjoins the lounge. Assisted bathing facilities are provided and all rooms have call bells. Suitably qualified care staff provide personal care within a relaxed, friendly atmosphere. The Registered Providers are committed to training their staff and over 50 have achieved the NVQ level 2 or above in care. The General Practitioner’s surgery is close by and the home maintains a very good rapport with the local Doctors, District Nurses and Community Psychiatric Nurses. There are opportunities for service users to socialise and visitors are actively encouraged. The home’s fees range from £290-£350 per week. The Hollies DS0000009041.V325955.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on the 14th February 2007, between 09.00 and 14.00 hours. The inspector met with the registered manager, staff, and residents. The inspector does not doubt the individual care provided to residents, and recognises the benefits afforded to residents by the hard-working, stable and established staff team and the registered manager. Residents were relaxed and comfortable in their interactions with each other and staff. Staff were observed to interact with residents in a manner that respected their dignity and rights as an individual. The requirements and recommendations identified in this report lead to an overall conclusion that the home offers a good level of service to residents. What the service does well: What has improved since the last inspection? What they could do better: The Hollies DS0000009041.V325955.R01.S.doc Version 5.2 Page 6 The registered provider must do more to ascertain the views of others on the service offered by the home. The registered provider must ensure that records required for inspection are available for inspection. The registered manager should ensure that staff provide a picture of the resident’s day in their entries in the care notes. More could be done to demonstrate choice at meals. The laundry facilities could be improved. 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 summary of this inspection report can be made available in other formats on request. The Hollies DS0000009041.V325955.R01.S.doc Version 5.2 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 The Hollies DS0000009041.V325955.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. National Minimum Standards 3 and 6 were inspected. This judgement has been made using available evidence including a visit to this service. Admissions are not made to the home until a full needs assessment has been undertaken. The staff team are qualified and experienced to work with the needs of the resident. The home employs staff who understand the cultural expectations of the residents, most of which are from the local area. EVIDENCE: The care documentation of the most recent admission to the home shows that a care needs assessment was carried out prior to admission. Each resident has a plan of care. A skilled and experienced member of staff always undertakes the assessment. The registered manager confirms that assessments involve the resident and/or their representative wherever possible. There is a high value on responding to individual needs for information, reassurance and support, as evidenced by the inspector’s observations of staff interactions with The Hollies DS0000009041.V325955.R01.S.doc Version 5.2 Page 9 residents during the course of the inspection. The home has a fax facility to assist with assessments provided from outside of the local area. The home states that a trial period is offered in the Statement of Purpose. The registered manager is reviewing the Statement of Purpose and intends to expand on this statement to better describe the options available to prospective residents (e.g. visit for meals). The home does not provide intermediate care. The Hollies DS0000009041.V325955.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. National Minimum Standards 7, 8, 9, and 10 were inspected. This judgement has been made using available evidence including a visit to this service. The home has a strong ethos of involving residents in all aspects of their life. The health needs of residents are met. All residents have a robust care plan. Residents are protected by the safe storage, administration, and disposal of medicine. Residents are treat with respect, their dignity and rights acknowledged. EVIDENCE: Each resident has a plan of care that is written in plain language, is easy to understand, and considers all areas of the individual’s life including health, personal and social care needs. The plan also includes a risk assessment. Areas have been identified where staff are willing to support residents to take some risks which may have an impact on their rights (e.g. access to the local community, helping out around the home. The Hollies DS0000009041.V325955.R01.S.doc Version 5.2 Page 11 Staff have skills and ability to support and encourage residents to be involved in the ongoing development of their plan and make the process interesting, and worthwhile using a variety of ways (e.g. appointing key workers who build up special relationships with residents and work on a one to one basis). Care plans are reviewed regularly, but the registered manager should do more to ensure the involvement of the resident and/or their representative in this process. The health care needs of the residents are managed and met by visits from local health care services. Residents’ personal aids are well maintained and the home provides the necessary aids and equipment to support both staff and residents in daily living. The home works to a medication policy supported by procedures and practice guidance. All the staff have undertaken ‘Safe Handling of Medicines’ training. The medicine administration records were seen to be in good order. The home has an agreement with their supplying pharmacist who inspects the medicines. Resident’s prescription sheets are kept. Attention is given to ensuring privacy and dignity when delivering personal care. Staff were observed to make every effort to enable residents to choose who delivers their care and respect their preferences. Interactions between staff and residents were ‘adult’ in nature, recognising the residents’ rights and worth. Induction training covers privacy and dignity. The Hollies DS0000009041.V325955.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. National Minimum Standards 12, 13, 14, and 15 were inspected. This judgement has been made using available evidence including a visit to this service. More could be done to demonstrate that the residents’ lifestyle meets their expectations and preferences. Residents are able to maintain contact with family and friends. Residents are encouraged to exercise choice and control over their lives, though more could be done in this area. A wholesome appealing diet is provided. EVIDENCE: Staff are aware of the need to plan the routines and activities of the home in a way which meets the choice and wishes of residents. There is a monthly activity plan, though this is somewhat sparse (only three entries for January). The home has developed a system for displaying information and bringing attention to community events and activities. On the day of the inspection the communal area wall indicated that it was Valentines Day. The Hollies DS0000009041.V325955.R01.S.doc Version 5.2 Page 13 Policies, procedures and guidance promote residents independence and choice. Residents are given the opportunity to take part in a variety of activities both within the home and in the community, though this is not always recorded and the records do not therefore reflect the efforts of the staff. Entries in the care notes are generally of a generic nature, providing little information about how the resident spent their day. The registered manager should ensure that the resident’s lifestyle is better recorded in the care notes, including participation in any activities. There is a visitors’ book. The home has open visiting arrangements, and there are visits from members of the community including the local church. The design of the home provides seating areas within the communal areas of the home where residents can entertain their visitors, in addition to the privacy of their own room. It is clear that the home encourages individuals and groups from the community to visit the home. Staff will support those residents who need help in financial matters, they work to a clear robust policy that protects the residents from financial abuse and clearly directs staff in their practice. The home is able to offer residents information and telephone numbers for contacting independent people who will act as advocates on the residents’ behalf where the resident prefers the help of an independent person. Residents have the choice to bring a limited amount of small goods with them on admission to the home and are encouraged to keep personal items, which are important to them in their own room. The food in the home is of good quality, well presented and meets the dietary needs of residents. The cook is experienced, and staff are trained to help those residents who need help when eating and are sensitive in their approach. Residents are able to choose to eat in their own room if they wish. The menu does not demonstrate choice being available at meals, and the registered manager confirmed that though an alternative would be made available this is currently based on the residents’ known likes and dislikes rather than expressed choice. The registered manager should ensure that the menu shows the choices available at meals, and that residents are consulted about their choice. The Hollies DS0000009041.V325955.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. National Minimum Standards 16 and 18 were inspected. This judgement has been made using available evidence including a visit to this service. The home has a proactive approach to the welfare and best interests of residents. Residents receive the information they need and their legal rights are protected. Residents are protected from abuse. EVIDENCE: The home has received one complaint since the last inspection, though none have been notified to the Commission for Social Care Inspection. The home has responded appropriately, informing the Commission for Social Care Inspection and other relevant agencies. The registered manager undertook to ensure that the complaints procedure clearly shows the contact details for the local Adult Social Care office. The policies and procedures regarding the protection of residents are regularly reviewed and updated. The service is clear when incidents need external input and who to refer the incident to. Training of staff in the area of protection is regularly arranged by the home. Residents spoken with confirmed that they feel safe. The Hollies DS0000009041.V325955.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. National Minimum Standards 19 and 26 were inspected. This judgement has been made using available evidence including a visit to this service. The home provides safe, comfortable accommodation that is personalised, wherever possible, to reflect individual service user preferences. The layout and location of the home is suitable for its stated purpose. The home was seen to be clean throughout on the day of the inspection. EVIDENCE: Although the maintenance records were not available for inspection, the fabric of the building supports the assertion that the building is well maintained. There are in places some steps to negotiate, but access is generally good, aided by good size corridors. There is a stair lift to assist with access between floors. There is sufficient communal space. Residents’ bedrooms were seen to The Hollies DS0000009041.V325955.R01.S.doc Version 5.2 Page 16 be comfortable and personalised to varying degrees. The home provides aids and equipment to meet the care needs of the residents. It is a very pleasant, safe place to live with rooms that meet the NMS or are larger and some have en-suite facilities. Where rooms are shared it is only by agreement, and screens provided for privacy. Residents are always given the choice to move into a single room when one becomes vacant. They have the choice to bring small personal items of furniture into the home. All the homes fixtures and fittings meet the needs of the residents and can be changed if their needs change. There were works being carried out in the main road by the local water company, which caused a break in the supply of water to the home. The registered manager made provisional arrangements with the water company at the time of the inspection to ensure the continuing supply of water. The Registered Provider should replace the existing domestic-type washing machines with an industrial-type machine (with a sluice facility). The Registered Provider should consider; converting the toilet opposite room 12 to a walk-in-shower room; converting the unused bathroom on the same floor to a laundry room; converting the existing small laundry area for additional storage. The Hollies DS0000009041.V325955.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. National Minimum Standards 27, 28, 29, and 30 were inspected. This judgement has been made using available evidence including a visit to this service. A skilled and committed staff team, in sufficient numbers, meets residents’ needs. Residents are protected by the home’s adherence to a robust employment procedure. EVIDENCE: There were 20 residents living at The Hollies on the day of the inspection, (one elsewhere at the time), with the registered manager, and 3 care staff, supported by a cook and a housekeeper on duty. There are 19 staff, not including the registered manager, 13 of which have achieved NVQ Level 2 or higher (approximately 75 ), and a further 4 are undertaking this training. The registered manager showed the inspector the interview records relating to recent applicants for a care position at the home. The recruitment of good quality carers is seen as integral to the delivery of an excellent service. The service is highly selective, with the recruitment of the right person for the job being more important than the filling of a vacancy. The home operates a robust recruitment procedure that clearly defines the process to be followed. This procedure is followed in practice with the service The Hollies DS0000009041.V325955.R01.S.doc Version 5.2 Page 18 recognising the importance of effective recruitment procedures in the delivery of good quality services and for the protection of residents. Staff are encouraged to undertake external qualifications beyond the basic requirements. New staff undertake an in-house induction, and the most recent employee is doing this. The registered manager must ensure that a National Training Organisation compliant induction programme is in use (www.skillsforcare.org.uk). The Hollies DS0000009041.V325955.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. National Minimum Standards 31, 33, 35, and 38 were inspected. This judgement has been made using available evidence including a visit to this service. The Hollies is a well managed home that benefits from an established and stable staff team. The home should do more to demonstrate that it is run in the best interests of the residents. Residents’ financial interests are safeguarded. Records required for inspection were not available for inspection so it was not possible to ascertain without doubt the health, safety and welfare of residents and staff. EVIDENCE: The registered manager has worked within the home for approximately 17 years. The registered manager has achieved the NVQ Levels 2,3 and 4 in care, The Hollies DS0000009041.V325955.R01.S.doc Version 5.2 Page 20 and has also completed the Registered Manager’s Award. She has the A1 and A2 Assessors qualification and is the Moving and Handling trainer for the home. The Inspector observed clear lines of accountability within the home and with the registered providers who are involved with the managing of the home on a day-to-day basis. An experienced deputy manager supports the registered manager. The manager ensures that the policies and procedures are followed by staff. Staff have practice handbooks and easy access to all documents, which are discussed during supervision, staff training and team meetings. Whilst there are quality assurance questionnaires available, these are not in use. The registered provider must operate a system for reviewing and improving the services offered by the home, publishing a summary of the findings (possibly in the home’s Service User Guide). The home encourages residents who wish and are capable, to manage their own money and valuables. Residents’ finances are stored securely, recorded, and supported by receipts. The registered manager undertook to ensure that the records were amended to show the actual amounts received so that this cross-referenced with the savings records. Only small amounts are held on the premises. Each resident has his or her own bank account. Records relating to the maintenance and safety of the residents and staff (e.g. boiler service, fire equipment maintenance) were not available for inspection, though these have been available at previous inspections and for this reason the inspector judges that the home is safe. The registered provider must ensure that required records are available for inspection. The Hollies DS0000009041.V325955.R01.S.doc Version 5.2 Page 21 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 1 X 3 X X 2 The Hollies DS0000009041.V325955.R01.S.doc Version 5.2 Page 22 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 OP28 Regulation 18 Requirement The registered manager must ensure that a National Training Organisation compliant induction programme is in use (www.skillsforcare.org.uk). The registered provider must operate a system for reviewing and improving the services offered by the home, publishing a summary of the findings (possibly in the home’s Service User Guide). The registered provider must ensure that required records are available for inspection. Timescale for action 01/04/07 2. OP33 24 01/06/07 3. OP38 17 01/03/07 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 OP7 Good Practice Recommendations Care plans are reviewed regularly, but the registered manager should do more to ensure the involvement of the resident and/or their representative in this process. DS0000009041.V325955.R01.S.doc Version 5.2 Page 23 The Hollies 2. 3. 4. OP12 OP15 OP21 5. OP26 The registered manager should ensure that the resident’s lifestyle is better recorded in the care notes, including participation in any activities. The registered manager should ensure that the menu shows the choices available at meals, and that residents are consulted about their choice. The Registered Provider should consider; converting the toilet opposite room 12 to a walk-in-shower room; converting the unused bathroom on the same floor to a laundry room; converting the existing small laundry area for additional storage. The Registered Provider should replace the existing domestic-type washing machines with an industrial-type machine (with a sluice facility). The Hollies DS0000009041.V325955.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD National Enquiry Line: 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 © 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 DS0000009041.V325955.R01.S.doc Version 5.2 Page 25 - 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. 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