Inspection on 04/11/08 for The Hollies & Hollies Lodge

This inspection was carried out on 4th November 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Hollies & Hollies Lodge 14/11/06

The Hollies & Hollies Lodge 22/11/05

The Hollies & Hollies Lodge 14/06/05

The Hollies & Hollies Lodge 07/12/04

The Hollies & Hollies Lodge 30/06/04

The Hollies & Hollies Lodge 22/01/04

Similar services:

Chesham House

Argyll House

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Hollies & Hollies Lodge Brick Kiln Lane Morningthorpe Norwich Norfolk NR15 2LH     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Susan Golphin     Date: 0 4 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 24 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 24 Information about the care home Name of care home: Address: The Hollies & Hollies Lodge Brick Kiln Lane Morningthorpe Norwich Norfolk NR15 2LH 01508530540 01508530540 info@holliesrch.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Linda Ann Quarendon Type of registration: Number of places registered: Calrhyros Ltd care home 23 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home The Hollies and Holly Lodge is an adapted and extended house situated in a rural area close to the village of Long Stratton in South Norfolk, and provides residential accommodation in single rooms, for people with an enduring mental illness. The service provides personal care and supports people to maintain their individual lifestyle. There are a range of activities and social events that take place on a daily basis including therapy sessions, outings or shopping trips for which transport is readily available. The fees per week range from £350-450 per week. 0 20 Over 65 3 20 Care Homes for Adults (18-65 years) Page 4 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The unannounced inspection was carried out over one day, a total of seven and a half hours. the registered provider and manager were present throughout the inspection.The report contains information from the Annual Quality Assurance Assessment document the previous inspection report and from notifications received from the service since the last inspection carried out on 14th November 2006. During the course of the day we were able to tour the premises, talk to residents and staff on duty and discuss the progress and future plans for the service with the management. A small sample of records relating to staff and residents were also seen on the day. Care Homes for Adults (18-65 years) Page 5 of 24 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 6 of 24 Care Homes for Adults (18-65 years) Page 7 of 24 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good procedures and processes in place for assessing and monitoring the needs of residents and establishing care plans. Evidence: There is good information about the Hollies available to everyone who may wish to use the service. There is a website with details of the service and facilities which can be accessed by prospective clients and commissioners alike. Each residents plan of care and support is established with the resident and with their relatives or advocates and the manager of the service. Supporting mental health care professionals are also consulted and their advice sought where appropriate. There are good systems in place for monitoring progress and changes in residents needs. Every resident has a personal care diary which they can use to record their own thoughts and comments about their care and support or about how they are feeling. The diaries belong to the residents and are maintained by them unless they wish to share the contents with their key worker during the review process. The residents spoken to on the day said that they are asked about their care and what they want to do each day. Care Homes for Adults (18-65 years) Page 9 of 24 Care Homes for Adults (18-65 years) Page 10 of 24 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good processes in place to ensure that residents are involved in the care planning process which affects their quality of life. Staff understand the importance of residents being supported to take control of their lives and make their own decisions and choices. Evidence: From the information provided and from the discussions on the day, residents have as varied and individual lifestyle as they can given the complexities of their mental health needs. Good examples of support and care delivery were provided where residents are making decisions about day to day things albeit with guidance and advice and within agreed paremeters of risk. The management and staff focus on positive behaviour and activities that offer personal interest and social stimulation and promote individual lifestyles. The manager and staff have completed training in the Mental Capacity Act and were Care Homes for Adults (18-65 years) Page 11 of 24 Evidence: able to give an example of how one resident has been supported through a difficult process of decisionmaking around managing and reorganising his finances and has been assisted to seek guidance from independent advocacy. Care Homes for Adults (18-65 years) Page 12 of 24 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are excellent processes in place for seeking and acting on the views of the residents which promote personal and individual lifestyles in the home and community. There are good meal and menu choices available to residents that promote their nutritional needs and general well being. Evidence: From the information provided and the discussions with residents and staff the service provides a range of social activities and events that people can access on a daily basis. There are regular outings and opportunities to visit friends and relatives for those who wish to do so. Examples were given of escort and travel arrangements to visit one residents family that have been successfully tailored to meet their needs and reduce feelings of anxiety about the visits. Care Homes for Adults (18-65 years) Page 13 of 24 Evidence: Residents expressed positive comments about the menu and meal choices available to them including specialist diets and vegetarian dishes. Residents are encouraged to pursue their interests including their faith or religion and the manager said that they can offer advice or assist residents to search the internet for practical things or information on hobbies or interests. During the discussions residents talked about watching television and going out shopping and also looking forward to seasonal events and activities held at the Hollies. A bonfire party is planned for the 5th November and a Christmas high tea party on the 7th of December. One resident said that nothing is too much trouble for the staff here and its nice living here. Residents are able to enjoy a full and stimulating lifestyle with a range of options that they can choose from. The service actively encourages innovative opportunities for people to develop and maintain their own way of life within the limitations of their mental health needs. Care Homes for Adults (18-65 years) Page 14 of 24 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This service provides excellent support and care to residents with enduring mental health needs. There are robust procedures in place for the management and adminstration of medication. Evidence: On the day of the inspection two residents were seen separately and four seen in a small group. All confirmed that they are well supported by the management and staff. Again, good examples of individual care and assistance were provided during the interviews and it was said that residents are encouraged to be involved in the decision making about their lifestyle and daily activities. None of the current residents can safely manager their own medication, and there is a clear and well managed system in place to ensure that all medicines are issued at the appropriate time, stored safely and reviewed and audited regularly.Staff receive training in the management and adminstration of medication. Residents are offered regular health checks and screening especially those on controlled medication. The staff seen on the day spoke confidently and competently about their role and the Care Homes for Adults (18-65 years) Page 15 of 24 Evidence: support they provide. From the discussions with staff and management they are able to demonstrate a clear understanding of the needs of people who have an enduring mental illness and are focused on creating a trusting and inclusive service for everyone. Residents seen on the day were very complimentary about specific members of staff and the management, with good examples of individual help and assistance with everyday things such as managing their finances meeting family and shopping. Care Homes for Adults (18-65 years) Page 16 of 24 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good procedures in place to protect residents from abuse and self harm. There is a clear complaints process in place which residents and staff can access easily and management act appropriately to the concerns raised. Evidence: The service continues to maintain a clear complaints process. Staff spoken to on the day said that they feel confident and competent about raising issues with the management and when they have done so the matter has been treated seriously and if the issue has been on behalf of a resident dealt with promptly and openly. Residents said that they can go to any of the staff for help or advice but if they are worried at all about anything will go to see the manager Linda Quarendon or Steve Orrick the registered provider as they are always around and available and can help with everything said one resident. All the support staff confirmed that they have completed safeguarding adults training and could demonstrate how they would respond in the event of an alert. Some of the more established staff have completed training in conflict management and non abusive intervention training and refresher courses and updates on safeguarding are regularly updated. Care Homes for Adults (18-65 years) Page 17 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are provided with a homely and safe environment that offers a comfortable range of living space and facilities. Evidence: The management have carried out a number of improvements to the premises in the last two years and these include redecoration of nineteen of the twenty three rooms, carpet replacement in two thirds of the rooms and new hand basins and curtains and linens in half of the rooms. A small office has been created out of one of the smaller bedrooms and a clinical room established which provides a separate space for use by health care professionals and also offers greater confidentiality to residents during consultations and treatments. The major development proposal for the site is still under consideration. The long term plan is to develop the site with a purpose built unit and self contained accommodation however the planning application has not yet been accepted despite reviews and revisions of the plan. Despite this delay The registered provider is continuing to upgrade the premises over the next three years and will include improvements that will provide five walk in showers and six WCs . The standard bathrooms are also to be upgraded and en-suite facilities will be installed in residents rooms where there is capacity to do so. This major upgrade will greatly enhance the personal living space for Care Homes for Adults (18-65 years) Page 18 of 24 Evidence: residents. All the residents doors to their rooms have been replaced with upgraded fire doors, in keeping with the new legislation on smoking in public places. In the service areas additional cupboard space has been created and this has improved the working space in the staff room. To the rear of the premises a separate kitchen /diner has been created and residents can access and use this facility as they wish. As previously stated in this report residents have access to local amenities and transport is made available every day for shopping trips and outings. On the day of the inspection the premises and service areas were clean and well maintained. Care Homes for Adults (18-65 years) Page 19 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good recruitment and training procedures in place that ensure that residents benefit from well trained and supervised staff Evidence: From the information provided and from the discussions with the residents, staff and management the staffing structure and duty rotas for this service are based on delivering the best outcomes for the residents throughout the day and night. People who use the service including other health care professionals commented that the staff consistently demonstrate that they are skilled and knowledgeable about the care and support needs of the current resident group. Residents said that they can rely on the staff for everything and help me to do what I want said one. Informal and formal supervision sessions take place on a regular basis and staff seen on the day said that the support from the manager helps to maintain and improve outcomes for residents.Discussions and reviews about input and practice take place as part of the supervisory and appraisal process. NVQ training is promoted and staff are well supported with formal training as the manager is an NVQ assessor and trainer. Care Homes for Adults (18-65 years) Page 20 of 24 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is well managed with clear leadership and direction and where the health and safety of residents and staff are promoted and protected. Evidence: This service is well managed and well maintained by an appropriately qualified and experienced manager and registered provider who can offer people the benefits of a well run home. Residents views are sought and used to influence changes or improvements where possible. Despite the complex mental health needs of the residents their comments about the service are sought and wherever possible their views are used to influence change. Residents seen on the day said that they are asked about living at the Hollies and two said that they didnt want to go anywhere else. At least half of the resident group have lived in the home for between ten and twenty years and confirmed that they have the stability and security they need and a lifestyle they can influence and manage for themselves within their own limitations. Care Homes for Adults (18-65 years) Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 22 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 23 of 24 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 24 of 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!