Inspection on 03/06/05 for The Hollies

This inspection was carried out on 3rd June 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 29/11/05

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 Pat Edwards-Jackson Unannounced 3 June, 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 D53 - D02 The Hollies V231177 100605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Hollies Address Florida Street, Castle Cary, Somerset, BA7 7AE 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) 01963 350709 01963 351396 M & J Homes Ltd Mrs Judith Marion Adams Personal Care home only 12 Category(ies) of Old age (12) registration, with number of places The Hollies D53 - D02 The Hollies V231177 100605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15 December, 2004 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 situated 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 providers are closely involved in the day to day running of the home. Mrs Adams provider/manager is supported by a small staff team. The accomodation is arranged on two floors. There is a stair lift for those with mobility needs. Communal areas are avialable on both floors of the home. At the rear of the property an enclosed garden area is available for the people living at the home. The conservatory/dining area overlooks the gardens. The home has limited parking space for visitors at the front of the property. The Hollies D53 - D02 The Hollies V231177 100605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 1 day (5.5 hrs) and was conducted by one inspector. The majority of standards were inspected on this occasion. For standards not assessed the reader is advised to read this report in conjunction with the previous inspection report 15/12/04. A tour of the premises took place. All bedrooms and all communal areas were seen. Records relating to care, medication and staff were examined. There were 1:1 discussions with 6 service users plus small group discussions involving the remaining number. The two care staff, on duty, were spoken with during the course of the inspection. The providers Mrs Adams (manager) and Mr Morris were available throughout the day and assisted with the inspection. Feedback was provided to them at the end of the inspection visit. What the service does well: What has improved since the last inspection? It should be noted that the previous inspection was the first involving the current providers who at that time, had recently taken over the home. All of the requirements identified at the previous inspection have been met as follows; 1. Care plans are now reviewed monthly. The Hollies D53 - D02 The Hollies V231177 100605 Stage 4.doc Version 1.30 Page 6 2. The staff have received training in medication management and administration. 3. Recruitment procedures have been improved. 4. The staff, have been instructed in fire safety and evacuation procedures are clearly posted throughout the home; and staff are being provided with statutory training are needed - a training programme has been devised (a copy was made available during the inspection). Of the nine recommendations made it was pleasing to note that seven of these had been acted upon the remaining two were being considered by the providers as part of their development programme of works for the home; 1. The Statement of Purpose and service user guide was available in the home. 2. Comprehensive assessments of needs are undertaken prior to admission 3. The medication policy has been updated and the signatures of all staff administering medication are listed. Medication storage arrangements have been reviewed. 4. A plan of activities has been devised but will develop further. 5. The complaints procedure is freely available together with information listed under (1) above. 6. Provision for lockable spaces in bedrooms are currently being addressed on an individual basis. 7. Risk assessments are in place; and heating in the conservatory area is under review. 8. The manager is currently developing the staff induction programme and a system for providing formal supervision sessions. What they could do better: The providers have made significant progress to develop the service since the previous inspection. They are keen to ensure that the service they provide is of a good standard and are committed to developing it further. The addition of information about Advocacy services in the recently developed service user guide folder, would further improve this resource. Please contact the provider for advice of actions taken in response to this The Hollies D53 - D02 The Hollies V231177 100605 Stage 4.doc Version 1.30 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Hollies D53 - D02 The Hollies V231177 100605 Stage 4.doc Version 1.30 Page 8 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 D53 - D02 The Hollies V231177 100605 Stage 4.doc Version 1.30 Page 9 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; 2; 3; 4;5. The majority of resident service users have lived at the home for a number of years. The home rarely has vacancies. Information is available to help prospective service users and their families make an informed choice about placements here. Needs are assessed prior to admission; and this assessment process continues following admission to ensure placements are appropriate. The providers encourage visits to the home. Intermediate care is not provided EVIDENCE: The recently devised Service User Guide and Statement of Purpose was seen. This clearly sets out the service provided. It also contains information and guidance for service users and their families in the event of a concern or complaint about the service. A sample of care and support plans were seen these detailed the assessed care and support needs of the individuals concerned. There was evidence of relative and service user involvement in the care plans including risk assessments. The manager has also devised a form to ensure essential information is taken with any service user admitted to hospital. The Hollies D53 - D02 The Hollies V231177 100605 Stage 4.doc Version 1.30 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;10;11. Health and personal care needs are clearly identified in collaboration with service users, their families, social workers and medical practitioners. Health care needs are appropriately met, in collaboration with the community health care team. The manager ensures that health care needs are kept under review and appropriate referrals and help are sought. Service users are treated with respect by staff. Kind and sensitive support is provided for those affected by deteriorating conditions. EVIDENCE: A sample of care and support plans were seen. These provided evidence that health, personal and social care needs were identified and that strategies were in place to ensure they were met. For example one person with diabetes was closely monitored and the home ensured her dietary needs were catered for. Moving and handling assessments were in place for those needing assistance with mobility. One care plan clearly documented the actions taken by the home in response to a service user who had sustained a fracture. This demonstrated that appropriate and timely action had been taken. Following a visit to hospital this person made a good recovery. The medication records and the medication storage arrangements were seen. The manager confirmed that she audits the medication system on a monthly basis and continues to provide guidance to staff to ensure they maintain The Hollies D53 - D02 The Hollies V231177 100605 Stage 4.doc Version 1.30 Page 11 accurate records. Staff spoken with during the inspection were able to describe how the system worked and the training they had recently received regarding medication. One service user whose condition has deteriorated was found to be as comfortable as possible. Medication had been prescribed by her GP to help with pain control. This service user was able to seek help when she needed it and staff were observed to unobtrusively monitor her needs. Her care and support plan clearly documented her changing condition and the steps which had been taken to address this. There was also evidence that her family were being kept informed of her condition. The Hollies D53 - D02 The Hollies V231177 100605 Stage 4.doc Version 1.30 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 standard(s) 12; 13; 14; 15 The lifestyle experienced by the current resident group appears to meet their needs. Religious needs are recognised by the home and some religious services are held in the home for those who wish to participate. Family members are encouraged and supported to visit the home on a regular basis. Choice is encouraged and promoted. The meals provided are wholesome and appetising and a good range of options is available. Personal preferences and special occasions are catered for. Meals are taken either in the communal dining room or individual bedrooms if preferred. EVIDENCE: The sample of care and support plans outlined individuals preferences – service users were able to confirm that their preferences were acknowledged and met. E.g. for one person ‘likes to spend a lot of time in her room, but does come down for lunch’. Conversation with this person confirmed that they were happy with this arrangement and preferred to occupy themselves in the privacy of their own room but was able to seek company out when she felt like it. Another person had grown up on a farm and had been used to doing lots of heavy work. Now in her 90’s she prefers to take life a bit easier and spoke positively about her life in the home and the friendships she had made. The Hollies has two pet cats that have lived at the home for a number of years. When speaking with a group of service users it was clear that the cats were The Hollies D53 - D02 The Hollies V231177 100605 Stage 4.doc Version 1.30 Page 13 popular with them. As one service user commented ‘they usually head for my lap’. Discussion with a relative during the inspection confirmed that visiting family members are made to feel welcome and involved in supporting The visitors book in the entrance hall records the fact that there are frequent visitors to the home. Conversation with the manager confirmed that she is keen to promote opportunities for independence and for service users to try new experiences. This was particularly relevant to meals and some service users demonstrated that they were happy to try new dishes when the opportunity was offered. The home has a ‘tuck shop’ trolley providing essentials for those who feel unable or do not wish to go out shopping. One service user commented that ‘my daughter usually helps me with shopping’…’but the tuck shop is useful if I run low’. The Hollies D53 - D02 The Hollies V231177 100605 Stage 4.doc Version 1.30 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 standard(s) 16 A system is in place to ensure service users; their families and supporters are able to make their concerns known. EVIDENCE: The Service user guide developed since the previous inspection contains information to guide those wishing to make a complaint. Conversations with service users and a visiting relative confirmed that they would feel confident in raising concerns. Conversations with the management team confirm that they are keen to know when there are problems, so that they can be addressed as quickly as possible. The Hollies D53 - D02 The Hollies V231177 100605 Stage 4.doc Version 1.30 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 standard(s) 19; 20; 21; 22; 23; 24; 25; 26 Individual bedrooms are furnished and equipped to suit the needs of their occupants. The environment is well maintained and measures are taken to ensure the safety and well being of those living in the home. The home is clean and a good standard of hygiene is maintained throughout EVIDENCE: A tour of the premises took place. Individual bedrooms were found to be pleasantly decorated and comfortably furnished. There was a lot of personalisation e.g. family photographs, paintings and books. Furnishings had been adapted to suit individual needs e.g. in one persons room the easy chair had been placed on chair raisers to enable her to get in and out independently. Several people also had their own wheelchairs, primarily for getting out and about in the community. The stairway fitted with a lift is wide enough to allow safe access alongside the lift for anyone on foot. During the course of the inspection, service users were observed to confidently use the stair lift independently. The Hollies D53 - D02 The Hollies V231177 100605 Stage 4.doc Version 1.30 Page 16 Tour of the premises – The fire evacuation plan is clearly posted in the home and includes the names of service users and identifies the location of their rooms. The laundry area was clean and tidy. The providers had discussed relocation of the laundry at the previous inspection and intend re-locating the laundry in due course. Supplies of paper towels and liquid soap were found in all communal facilities. The only discernible odour on entry to the home was that of baking biscuits coming from the kitchen. Which added to the ‘homely’ atmosphere. The Hollies D53 - D02 The Hollies V231177 100605 Stage 4.doc Version 1.30 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 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; 29; 30 There was 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 provider/manager who works ‘hands on’ as part of the team. Recruitment procedures ensure that service users are protected. Staff receive training and are supported to become competent in their respective roles. EVIDENCE: At the time of this inspection the provider/manager was working alongside two care staff. The team were observed to work well and in an unhurried manner. A relaxed atmosphere was maintained throughout the course of this unannounced inspection. Staff were observed to show sensitivity and respect when assisting service users, providing gentle guidance and reassurance. A system is in place to ensure the whereabouts of staff are known at all times (via a series of pagers). This is important given the layout of the home and the relatively small number of staff in the home at any one time. Conversations with staff and the management team confirmed that they are supportive of staff development and provide opportunities for progression, which are appropriately monitored. Any areas of concern including poor performance are addressed by the manager, as evidenced in discussions with her and the sample of files seen. A sample of staff recruitment and training information was seen. These were found to be satisfactory as discussed with the provider. A training plan has been devised and this was seen during the inspection. The providers have ensured that the computerised system ‘flags up’ when individual training needs are due. The Hollies D53 - D02 The Hollies V231177 100605 Stage 4.doc Version 1.30 Page 18 The Hollies D53 - D02 The Hollies V231177 100605 Stage 4.doc Version 1.30 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 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; 36; 37; 38 ‘The Hollies’ is well run by the providers, who have a clear vision regarding the service they provide. The systems they have developed ensure staff are appropriately supervised at all times and service users are protected. There is a good level of communication between the providers, the staff, the people who live at the home and their relatives. EVIDENCE: Observations and service user comments during the inspection confirmed the home is well managed. The majority of service users, having lived at the home prior to the present providers taking it over last year. All those spoken with were positive about the change of ownership. A visiting relative, who had been in contact with the home for a number of years was very positive about the new providers and felt confident about the support his relative received. The Hollies D53 - D02 The Hollies V231177 100605 Stage 4.doc Version 1.30 Page 20 The providers have an approachable style, which welcomes comments. Service users spoken with during the inspection confirmed that they felt in safe hands. The staff on duty confirmed that they felt well supported and supervised in their work. The providers live a short distance from the home. The Hollies D53 - D02 The Hollies V231177 100605 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 3 3 x x 3 3 3 The Hollies D53 - D02 The Hollies V231177 100605 Stage 4.doc Version 1.30 Page 22 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 Regulation Requirement Timescale for action 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 Good Practice Recommendations The Hollies D53 - D02 The Hollies V231177 100605 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Riverside Chambers Castle Street Tangier Taunton TA1 4AL 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 D53 - D02 The Hollies V231177 100605 Stage 4.doc Version 1.30 Page 24 - 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!