Inspection on 29/11/05 for The Hollies

This inspection was carried out on 29th November 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 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 07/09/09

The Hollies 02/10/08

The Hollies 03/05/07

The Hollies 17/01/07

The Hollies 03/06/05

The Hollies 15/12/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE The Hollies Florida Street Castle Cary Somerset BA7 7AE Lead Inspector Stella Lindsay Announced Inspection 29th November 2005 10:00 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 DS0000061198.V251339.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. The Hollies DS0000061198.V251339.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Hollies Address Florida Street Castle Cary Somerset BA7 7AE 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) 01963 350709 01963 351396 M & J Care Homes Ltd Mrs Judith Marion Adams Care Home 12 Category(ies) of Old age, not falling within any other category registration, with number (12) of places The Hollies DS0000061198.V251339.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd June 2005 Brief Description of the Service: The Hollies is a residential care home providing care and support for up to 12 older people. The home is in Castle Cary, in a quiet residential road, close to the centre. Local amenties including shops, cafes, a small museum and the post office are close by. The home owners are closely involved in the day to day running of the home. The accommodation is arranged on two floors. There is a stair lift, but no shaft lift. There are two lounges, an attractive dining room, and a conservatory which overlooks an enclosed and sheltered garden. The home has limited parking space for visitors at the front of the property. The Hollies DS0000061198.V251339.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place on a Tuesday in November 2005, between 10.15 and 4.15pm. It involved a partial tour of the premises, and examination of care records, health and safety records, and the medication system. As well as discussion with the Registered Provider and the Team Leader, the inspector met with eight residents, a visiting relative and three staff on duty, and thanks all for their time. Comment cards were received from six residents, and the views expressed will be represented in the text. The Commission for Social Care Inspection has introduced key standards to be inspected over each inspection year. Therefore, unless it is felt necessary by the inspector, some standards will not be inspected. To obtain a full picture of the home please refer to the report of the inspection which took place on 3rd June 2005, when most of the core standards were inspected. What the service does well: What has improved since the last inspection? The staff team do well to maintain a service which responds to residents’ individual needs. Staff have been encouraged to develop and take on responsibilities. Maintenance and redecoration continue. Progress is being made on plans to develop the service, adding four bedrooms, plus office space and a new laundry and sluice. The Hollies DS0000061198.V251339.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. The Hollies DS0000061198.V251339.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 The Hollies DS0000061198.V251339.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): 1,2,3 Clear information is available to help prospective residents and their families make an informed choice, though some information still needs to be added. Needs are carefully assessed prior to admission. EVIDENCE: A Statement of aims and objectives and a Service Users’ Guide have been produced for the Hollies, and are given to new and prospective residents along with the Policy on Rights. The document needs to state that the home does not offer a service to people with advanced dementia or mental health problems. It must include the relevant qualifications and experience of the Registered Manager and staff. The fire precautions and associated emergency procedures must be included, and a useful way should be found to represent residents’ views of the service. An ‘Agreement for the provision of Residential Care at The Hollies’ is provided on admission, to clarify the terms and conditions. The Manager uses a clear and comprehensive format to assess the needs of prospective residents before offering accommodation. She has normally visited the person in their home to assess their care needs, but where this has The Hollies DS0000061198.V251339.R01.S.doc Version 5.0 Page 9 been impossible because of distance, she has ensured that she has sufficient information from previous carers. The Hollies DS0000061198.V251339.R01.S.doc Version 5.0 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 the following standard(s): 7,8,9 The manager ensures that personal and health care needs are kept under review and appropriate referrals and help are sought. The system for administration of medicines is sound, to promote residents’ good health. EVIDENCE: Care plans included the resident’s preferred daily routine, in good detail so that staff would know how to care for them. These were seen to be signed by the residents. They included duties for staff on each of the different shifts, and instructions for specific activities, eg safety of a resident who smokes. Moving and handling assessments were in place. Care assessments had been updated by the Team Leader, and a chart is kept on each resident’s file to show when the Registered Manager carries out her monthly check of the care plan. There was evidence of good collaborative working with District Nurses for the well being of the residents. The Continence Nurse had been to assess and advise. One resident said that ‘if anything’s wrong, they call the doctor quickly’, and that they felt lucky to be in such a nice home. The Hollies DS0000061198.V251339.R01.S.doc Version 5.0 Page 11 The Hollies has a policy for the safe administration of medications, and the Manager and Team leader ensure that it is put into practice consistently. Training on the safe handling of medication was received by five staff in January 2005. Staff who are competent to administer medication are listed at the front of the Medicine Administration Records, with a sample of their initial. Residents are enabled to administer their own medication if risk assessment shows this to be safe. A Controlled Drugs register is kept, and a mistake in recording had been promptly seen and put right by the Manager. A CD cupboard which meets the specifications of the Misuse of Drugs (Safe Custody) Regulations 1973 has been provided, but at the time of the inspection had not been bolted to the wall. Any drugs that need to be kept chilled are stored in a fridge in the office. Each resident has a letter signed by their GP, agreeing to the use of certain homely remedies, including their own preferred creams, bought without prescription. The Hollies DS0000061198.V251339.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,15 Choice is encouraged and promoted. The meals provided are wholesome and appetising and a good range of options is available. EVIDENCE: The day starts with breakfast being served to residents, who can choose whether they eat in their room or come to the dining room. The lunch menu was written up on a white board in the dining room. A choice of main course is not normally offered, but the cooks know residents’ preferences. For instance, on the day of the inspection the main course was plaice. Two residents had previously told the inspector that they would prefer fish fingers, and this was served to them. There was fruit or yoghurt available as an alternative to the lemony pudding, described as ‘delicious’ by a resident. A resident with diabetes was served with grapes and bananas in sugar free mousse. She said that the cook bakes sugar-free biscuits for her. A choice of hot snacks or sandwiches is served at tea-time, with a record of food eaten kept in the kitchen. Residents confirmed that night staff will bring them a cup of tea in the night if they want one. There were eleven people in residence at the Hollies at the time of the inspection, and two people attending for day care. Two residents were staying in their room all the time, one by personal choice, another temporarily on the advice of a District Nurse. Some people visit each other in their rooms. There The Hollies DS0000061198.V251339.R01.S.doc Version 5.0 Page 13 are videos and board games in a cupboard in the smaller lounge. A person is employed three afternoons per week to lead activities, and to take the tuck shop around. Residents were pleased to tell the inspector that the home owner had recently put on a firework party, with refreshments. The Hollies DS0000061198.V251339.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 The Home has a satisfactory Complaints procedure in place, but no record of how any concerns had been dealt with which would make people aware that their concern had been taken seriously, and action taken. EVIDENCE: The complaints procedure is given to all new residents in the Service User Guide. No formal complaints had been received. Advice was given to keep a record of any niggles, suggestions or issues raised, so that any action taken could also be recorded. There was a policy for Adult Protection and dealing with any allegation of abuse. Staff were clear about the need to report any anxiety to the Manager or Team Leader, and they are aware that any allegation would have to be reported to the Social Services Adult Protection Team immediately. The Hollies DS0000061198.V251339.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,24,25,26 The environment is well maintained and a good standard of hygiene is maintained throughout. Bedrooms and communal rooms are furnished and equipped to meet the needs of the residents. EVIDENCE: The Hollies is an attractive house, close to the centre of Castle Cary. There is room for a few cars to park outside. There is a small step to the main front door, but level access through another door (to the left). It is in good repair and well decorated. Fire escapes were clear, and external doors had alarms fitted, to alert staff if they were opened. There is an attractive and sheltered garden. It would benefit from smoother pathways to encourage and enable the residents to enjoy it. Many of the bedrooms look on to it, which is well liked by the occupants. There is plenty of communal living space, with two lounges, a dining room and a conservatory. The Hollies DS0000061198.V251339.R01.S.doc Version 5.0 Page 16 Grab rails had been fitted in toilets, according to individual needs. There is no shaft lift, but a stair lift up one of the two staircases. It was recommended that the home owner should provide a means of calling for assistance at the top of the stair lift. The toilet at the end of the upstairs corridor has no hand basin. If it remains a communal toilet, a hand basin must be fitted. The Manager stated that she is proposing to change the layout, and that it will become an en suite toilet for the adjacent bedroom. Suitable locks had been fitted to bedroom doors. There were sufficient electricity sockets. Rooms were well furnished, and there were plenty of the residents’ own personal effects. Radiators were guarded to protect residents from the risk of harm, and hot water was coming from bath taps at a safe temperature to avoid any risk of scalding. The home was clean and sweet-smelling throughout. The Sangenic system was in place for pad collection. Disposable aprons and gloves were available, and liquid soap and paper towels were provided in communal toilets. The home owners have plans for development of the home which include installation of a sluice. The Hollies DS0000061198.V251339.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 There were sufficient staff on duty at the time of the inspection to meet the needs of the people living at the home. Staff are supervised on a day-to-day basis by the Registered Manager who works as part of the team. EVIDENCE: Sufficient care staff are employed to meet the needs of the residents. No domestic staff are employed, so sometimes cleaning tasks have to wait if staff are busy with the residents. A cook is employed from 9am to 1.30pm. At night, there is one care assistant on duty. The Manager or Team Leader are always on call. Staff said that they feel supported, and residents said that they get help if they need it, and the night staff bring them a cup of tea if they want one. An extra person has been employed at night when a resident has been ill and needing constant attention. The Registered Manager must continue to monitor night care needs, to ensure safety for residents. A hoist has been provided, but is not in daily use. If any resident were unable to weight bear, a second staff member would be needed on the premises overnight. The Hollies DS0000061198.V251339.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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): 31,35,37,38 The Registered Manager maintains a caring and responsive service at the Hollies, fostering a sympathetic and respectful atmosphere, and promoting safe systems of work. EVIDENCE: The Registered Manager is qualified and experienced in the management of residential care. Staff on duty confirmed that they feel well supported by the Manager and Team Leader. Residents are enabled to keep control of their own finances, though currently only one does this. Others all accept help from family or solicitor. The Manager handles small amounts of cash on behalf of some residents. They have lockable storage space in their rooms, but some prefer not to handle The Hollies DS0000061198.V251339.R01.S.doc Version 5.0 Page 19 money. Every transaction is recorded, and the balance remaining. Advice was given to record either a signature from the resident, or a staff witness. Some residents’ personal records had been kept in a report book. This must stop, as residents’ records must all be kept separately, in case they ask to see them. Advice was given to record all residents’ information on separate sheets which can then be stored in their care plan. Fire extinguishers had been checked in August 2005. The fire precaution system is checked weekly by the home owner, and the professional six monthly service had been carried out on 05/08/05. The evacuation procedure and a current list of residents were displayed on both floors. All staff had received fire safety training on 07/11/05. The Manager has resources for continuing in-house up-dates, and had a record of staff viewing a video and completing a questionnaire in order to maintain their awareness of fire safety. The bath hoist had been checked, on 14/05/05. Electrical equipment had been tested for safety. The central heating had been serviced professionally on 29/10/05. Advice was given about the requirement to carry out a risk assessment with respect to Legionella, in order to avoid risk of illness. Water temperatures had been checked for safety. Most upper windows were restricted from opening wide, or a risk assessment was in place, but some action will be necessary in respect of the wide opening window in a first floor bedroom that was vacant. The security of the premises were weakened, as the side garden gate frame was in need of repair. The Hollies DS0000061198.V251339.R01.S.doc Version 5.0 Page 20 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 2 3 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 4 X X X 3 3 3 STAFFING Standard No Score 27 3 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 X 2 2 The Hollies DS0000061198.V251339.R01.S.doc Version 5.0 Page 21 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 OP1 Regulation Sch.1 Requirement The Statement of Purpose and Service Users’ Guide must include all the information required by Standard 1 and Schedule 1 of the Regulations. The Controlled Drugs cupboard must be bolted to the wall. Residents’ personal records must be kept individually, in accordance with the Data Protection Act. The gate post must be mended. A risk assessment must be carried out with respect to Legionella. Timescale for action 31/01/06 2 3 OP9 OP37 13(2) 17 24/12/05 24/12/05 4 5 OP38 OP38 23(2)(b) 13(4) 24/12/05 31/01/06 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 OP16 Good Practice Recommendations The Manager should keep a record of any suggestions or issues raised, so that any action taken could also be recorded. DS0000061198.V251339.R01.S.doc Version 5.0 Page 22 The Hollies 2 3 4 OP19 OP19 OP35 Access around the garden paths should be improved. The home owner should provide a means of calling for assistance at the top of the stair lift. The Manager should obtain the resident’s signature when withdrawing any of their cash from the safe, or two staff signatures. The Hollies DS0000061198.V251339.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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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