Inspection on 18/08/05 for The Hollies Nursing & Residential Home

This inspection was carried out on 18th August 2005.

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 Nursing &... 20/06/07

The Hollies Nursing &... 02/12/05

The Hollies Nursing &... 16/11/04

The Hollies Nursing &... 28/06/04

The Hollies Nursing &... 23/09/02

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE The Hollies Nursing & Residential Home Church Street Clayton-Le-Moors Accrington, Lancashire BB5 5HT Lead Inspector Janet Proctor Unannounced 19 July 2005 09:30 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 Nursing & Residential Home F57 F07 S22498 The Hollies V232797 190705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Hollies Nursing & Residential Home Address Church Street Clayton-Le-Moors Accrington Lancashire BB5 5Ht 01254 381519 01254 395477 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) The Hollies Nursing & Residential Home Ltd Care Home with Nursing (N) 42 Category(ies) of Physical disability (PD) 2 registration, with number Physical disability over 65 years of age (PD)(E) of places 36 Old age, not falling within any other category (OP) 32 The Hollies Nursing & Residential Home F57 F07 S22498 The Hollies V232797 190705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 Within the overall total of 42 a max of 36 service users requiring nursing care who fall into the category of PD(E) 2 Within the overall total of 42 a max of 32 service users requiring personal care of the category OP. 3 Within the overall total of 42 a max of 2 service users requiring personal care who fall into the category of PD. 4 Staffing for sevrice users requiring nursing care will be in accordance will be in accordance with the Notice issued on 4 November 1996. 5 The registered provider shall at all times employ a suitably qualified and experienced person who is registered with the NCSC as manager of The Hollies Nursing & Residential Home. Date of last inspection 16 November 2004 Brief Description of the Service: The Hollies provides 24 hour nursing and personal care for up to 42 people. The registered providers are The Hollies Nursing & Residential Home Ltd. The day-to day management of the home is undertaken by one of the registered persons and there is a Registered Nurse who takes responsibility for the care management of the residents. The home is situated in Clayton-Le-Moors close to local amenities including a park. The home is a large detached property with gardens, which are easily accessible to all service users. A parking area is available for use by visitors and staff. Accommodation is provided in single or twin-bedded rooms. There are no en-suite rooms but toilet and bathroom facilities are within easy reach of all rooms. A passenger and stair lift facilitates access to all areas of the home. Communal lounges and dining rooms are located on the ground floor.The home is situated in Clayton-Le-Moors close to local amenities including a park. The Hollies Nursing & Residential Home F57 F07 S22498 The Hollies V232797 190705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over 7 and a quarter hours on the 19th July 2005. The previous inspection was done on 16th November 2004 and information on the findings of this can be obtained from the home or from www. CSCI.org.uk . No additional visit had been made since the previous inspection. On the day of the inspection there were 35 residents at the home. Information was obtained from staff records, care records, and policies and procedures. Information was also got from talking to 8 service users, one of the registered persons, the care manager, 2 staff members and 2 visitors. A tour of the premises also took place. Wherever possible the views of residents were obtained about their life at the home. Due to memory and communication difficulties, some of the residents were unable to engage in conversation or make comment about their experience of living in the home. Detailed notes were taken, which have been retained as evidence of the inspection findings. What the service does well: Residents were cared for in a friendly and professional manner. This friendly atmosphere was also extended to visitors, who were encouraged and made to feel welcome. Wherever possible the residents’ choices in how they lived their lives were respected Residents spoken to said, “They don’t bother what time you get up or go to bed”, “I like to have supper about 8.00 pm and then go to bed”, “I choose to stay in my room all the time” and “I get up early”. Each resident had a plan of care. This document had details of what their personal and healthcare needs were and how staff were to meet these. Residents spoken to said that “The staff are champion”, “The staff are marvellous. They’re really good with me” and “The staff are all good, you can ask them to do anything”. Varied and well-presented meals were served. All the residents spoken to said that the meals were good. They said, “The food’s good and there’s plenty of it” and “It’s always good food”. Residents were provided with clean and nicely decorated bedrooms that were well maintained. They could make these as individual as they liked with their own ornaments and small items of furniture. The lounge and dining room were decorated in a homely and comfortable fashion, with a variety of armchairs, footstools, side tables and ornaments and wall pictures. The Hollies Nursing & Residential Home F57 F07 S22498 The Hollies V232797 190705 Stage 4.doc Version 1.30 Page 6 There were good recruitment procedures to ensure that staff were suitable to be employed to work with frail and vulnerable people. Sufficient training was given to new employees to ensure that they had the skills and competence to be able to do their work. What has improved since the last inspection? 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 Nursing & Residential Home F57 F07 S22498 The Hollies V232797 190705 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection The Hollies Nursing & Residential Home F57 F07 S22498 The Hollies V232797 190705 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Residents received a full assessment prior to moving into The Hollies with the result that their needs were known and met. EVIDENCE: Residents’ files contained copies of assessments completed by health and social care professionals. It was evident that it was also usual practice for the care manager to visit and assess prospective residents before offering them a place at the home. Following the assessment prospective residents received a letter confirming that their needs could be met at the home Intermediate care was not provided at The Hollies. The Hollies Nursing & Residential Home F57 F07 S22498 The Hollies V232797 190705 Stage 4.doc Version 1.30 Page 9 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 and 10 Resident’s healthcare needs were identified and met. Their personal care was delivered in a way that promoted their privacy and dignity. EVIDENCE: The individual care plans of 4 residents were inspected. These identified the personal care needs of each resident and had been written on the point of admission. The plans stated whether the resident needed prompting, assistance or full help. Staff spoken to said that they read the care plans. Care plans were reviewed monthly and it was evident that service users or their relatives had been involved in the care planning process Appropriate assessments for prevention of falls, prevention of pressure sores, nutrition, and moving and handling needs were undertaken. Directions were given to staff on how to meet these needs. One of the care plans contained insufficient information about the strategies used to prevent the formation of pressure sores. Residents were registered with a GP of their choice and had access to chiropody, audiology and optical services. Other professionals and specialists were contacted for advice when necessary. One of the residents had been referred to the physiotherapy department. The Hollies Nursing & Residential Home F57 F07 S22498 The Hollies V232797 190705 Stage 4.doc Version 1.30 Page 10 During the course of the inspection staff were seen to interact with residents in a friendly yet polite manner. There was evidence of good resident and staff relationships, which led to a good atmosphere in the home. All practices seen at the time of the visit showed that privacy and dignity was respected. A resident said, “They don’t just barge in, they always knock first.” The Hollies Nursing & Residential Home F57 F07 S22498 The Hollies V232797 190705 Stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15 Residents were able to make choices about their life at the home so that their lifestyle met their preferences. Resident’s social, cultural and recreational needs were met through links with their family and friends being maintained and opportunities to undertake activities within the home. The meals offered at the home were varied and nutritious and to the liking of residents. EVIDENCE: The residents who were able to give an opinion said that the daily routine was flexible and they were able to get up and go to bed at a time of their choosing. The plan of care gave information on the resident’s preferred daily routine and for staff to allow residents to make decisions wherever possible. The known interests of residents were documented in those whose plans of care were viewed. A range of activities were planned and implemented by staff and the programme of these was displayed. These activities included: board games, skittles, bible reading, sherry and shortbread, quizzes, and videos. Records were kept of which residents had joined in which activities and the level of participation. A resident said, “We play skittles, bingo and do quizzes. And there’s always music and the TV”. Another resident said, “It’s Tuesday today, we have a bible class this afternoon”. Staff were seen to ensure that residents were given the choice of participating in the day’s activity. The Hollies Nursing & Residential Home F57 F07 S22498 The Hollies V232797 190705 Stage 4.doc Version 1.30 Page 12 Visitors were welcome at the home. The residents could choose whether to see them in one of the lounges or in their bedroom. One resident said that his daughter visited him every day and was always made welcome. One visitor spoken to said that the management of the home had arranged a birthday party and that “they’d put on a marvellous spread” and “made a really special day” for the resident and her family and friends. Residents spoken to were happy with the meals at the home. Breakfast was served between 8.30 am and approximately 10.00 am to fit in with residents’ rising times. The menus were displayed and residents knew where this was. There was a choice of meals at every mealtime and the residents could have alternatives to the menu if they wished. If anyone required a pureed diet, this was served with all the components of the meal blended separately, which meant the meal looked more attractive and appetising. Staff were seen to serve the meal in a dignified manner with each food item being served separately and each resident being asked how much they would like. They gave sensitive and discrete assistance to residents who could not manage themselves. The records of meals served at the home were in enough detail to enable it to be determined whether the diet was satisfactory in relation to nutrition or otherwise. Fridge and freezer temperatures, cooking and serving temperatures were recorded. The Hollies Nursing & Residential Home F57 F07 S22498 The Hollies V232797 190705 Stage 4.doc Version 1.30 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 Residents were confident that their complaints would be taken seriously and acted upon. The procedures at the home ensured that residents were protected from abuse. EVIDENCE: A copy of the complaints procedure was displayed in the home and included in the information given to prospective residents. This gave clear directions on who to make a complaint to and that a response would be made within 28 days. The procedure also had the address and telephone number of the Commission. A system was available to record any complaints made. None had been recorded since July 2004. No complaints had been made directly to the Commission. A resident spoken to said, “I’ve no complaints. But I’m sure they would sort things out if I had”. There was a Whistle blowing procedure and an appropriate procedure for staff to follow should they suspect or witness an incident of abuse. These issues were discussed with staff during the Induction period. Formal training on Protection of Vulnerable Adults was being arranged for staff but had not yet been finalised. One member of staff spoken to confirmed that she had covered this in the NVQ qualification. The Hollies Nursing & Residential Home F57 F07 S22498 The Hollies V232797 190705 Stage 4.doc Version 1.30 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26 Residents were happy with their accommodation at the home and lived in a safe, clean, well-maintained environment. EVIDENCE: The home was clean and well maintained. The decoration and furnishings were homely and of a good standard. There was access to gardens that were attractive and well kept. Repairs were reported and action taken. Residents said, “” I have a room on my own”, “You can use your room when you want – but I like to sit downstairs or outside if the weather’s nice” and “The room’s are fine, I have a comfy bed”. The home was clean and odour free at the time of the inspection. A resident said “They keep the rooms clean”. The systems for maintaining hygiene included procedures for infection control. Plastic aprons and gloves were available to staff when undertaking care duties. There was a separate laundry room, which had sufficient and appropriate equipment to meet the laundry needs of the number of residents accommodated. The Hollies Nursing & Residential Home F57 F07 S22498 The Hollies V232797 190705 Stage 4.doc Version 1.30 Page 15 The Hollies Nursing & Residential Home F57 F07 S22498 The Hollies V232797 190705 Stage 4.doc Version 1.30 Page 16 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 and 30 The numbers, skill mix and competencies of staff on duty met residents’ needs. The recruitment procedures were thorough and ensured the protection of residents at the home. EVIDENCE: There was a duty rota showing the names and grades of staff and what hours they worked. The number of staff rostered for duty was sufficient for the number of residents living at the home. There was a Registered Nurse on duty 24 hours per day. There was at least one member of Domestic staff on duty each day and there were an additional 20 cleaning hours allocated for carpet cleaning. There was a Cook and a Kitchen Assistant on duty each day. All new employees received an Induction programme that covered: fire safety; moving and handling; health and safety; management issues; and working practices. A recently employed member of staff confirmed that she had done the Induction programme and that she had worked under supervision when she first started. Staff were also sent on the TOPSS Induction training programme. Other in-house training was also done. Recent topics had covered: eye care; catheters; pressure distribution mattresses; room comfort; and the use of yellow bags. Training in dementia care may also be of benefit due to the ‘aging’ population of some of the residents. 57 of the care staff had NVQ level 2 in care. The recruitment procedures included completion of an application form, a faceto-face interview, obtaining of references and a POVA First and CRB check. The The Hollies Nursing & Residential Home F57 F07 S22498 The Hollies V232797 190705 Stage 4.doc Version 1.30 Page 17 files for 4 new employees were checked. These showed that the procedures had been followed and all relevant details had been obtained. Only one file had a photograph of the member of staff. The Hollies Nursing & Residential Home F57 F07 S22498 The Hollies V232797 190705 Stage 4.doc Version 1.30 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 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) 38 The health, safety and welfare of residents was promoted and protected. The use of inappropriate footwear by staff meant that slip, trip or fall accidents could occur. EVIDENCE: Fire alarms and emergency lighting were checked regularly. There was a work based fire risk assessment. Water temperatures were checked and action taken to reduce temperatures if these were over 43 degrees Celsius. There was a current electrical installation certificate. Portable Appliance Testing was done. The servicing of the gas boilers and appliances had been done in March 2005. The hoists, stannah stair-lift and passenger lift had been serviced in June 2005. Risk assessments were done. Eight staff had received training in First Aid this year. Fire safety training was done by an external agent and was supplemented by an in-house fire safety video. Moving and handling training had been done and a member of staff was a ‘Trainer’ for moving and handling. A distance-learning course for infection The Hollies Nursing & Residential Home F57 F07 S22498 The Hollies V232797 190705 Stage 4.doc Version 1.30 Page 19 control had been completed by 8 staff. Access to a course on Protection of Vulnerable Adults was being sought. Two of the staff on duty were seen to be wearing inappropriate footwear. These were ‘mule’ type sandals with no heel and insubstantial soles. This type of footwear has the potential for the wearer to slip or trip and may contribute to accidents or falls. The registered person said that staff had been given proper advice on the correct footwear and promised to address this issue. The Hollies Nursing & Residential Home F57 F07 S22498 The Hollies V232797 190705 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 4 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x x x x x x x 2 The Hollies Nursing & Residential Home F57 F07 S22498 The Hollies V232797 190705 Stage 4.doc Version 1.30 Page 21 No 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 OP29 Regulation 19 Schedule 2 Timescale for action There should be proof of identity, 31/07/05 including a recent photograph of each member of staff employed. Requirement 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. 2. 3. 4. Refer to Standard OP8 OP16 OP30 OP38 Good Practice Recommendations Detailed information about the strategies used to prevent the formation of pressure sores need to be included if a resident was identified as being at risk. That formal training for staff in Protection Of Vulnerable Adults is undertaken by all staff. That training in dementia care is arranged. That staff always wear correct and appropriate footwear undertaking their work. The Hollies Nursing & Residential Home F57 F07 S22498 The Hollies V232797 190705 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection 1st Floor, Unit 4 Petre Road, Clayton-Le-Moors Accrington, Lancashire. BB5 5JB 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 Nursing & Residential Home F57 F07 S22498 The Hollies V232797 190705 Stage 4.doc Version 1.30 Page 23 - 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. 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