Inspection on 21/06/05 for The Hollies Rest Home

This inspection was carried out on 21st June 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 Rest Home 17/01/09

The Hollies Rest Home 04/02/08

The Hollies Rest Home 07/11/05

The Hollies Rest Home 21/03/05

The Hollies Rest Home 23/11/04

The Hollies Rest Home 09/03/04

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

CARE HOMES FOR OLDER PEOPLE The Hollies Rest Home 14/16 Park Road Southborough Tunbridge Wells Kent TN4 0NX Lead Inspector Maria Tucker Unannounced 21 June 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 Rest Home H56-H06 S24029 The Hollies Rest Home V226934 210605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Hollies Rest Home Address 14/16 Park Road Southborough Tunbridge Wells Kent TN4 0NX 01892 535346 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) Regal Care Homes Ltd Care Home 31 Category(ies) of Dementia - over 65 (30) registration, with number Old age (1) of places .The Hollies Rest Home H56-H06 S24029 The Hollies Rest Home V226934 210605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Care of one service user is restricted to one person whose date of birth is 21/12/1940 Date of last inspection 21 March 2005 Brief Description of the Service: The Hollies is a care home providing personal care and accommodation for 31 older people who are experiencing dementia. It is owned and operated by Regal Care homes Ltd. The home is located in Southborough, near Tunbridge Wells. It is close to shops and a bus route to the Town centre of Tunbridge Wells or Tonbridge. The home provides accommodation arranged on three floors. The premises are detached. There are two lounge/dining rooms on the lower ground floor and a conservatory. There are bedrooms on all three floors. There are gardens to the rear and parking at the front for several cars. The home employs care staff that work a rota which including waking night staff. In addition to the care staff there are domestic staff and a handyman. .The Hollies Rest Home H56-H06 S24029 The Hollies Rest Home V226934 210605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the first in the year running from April 1st 2005 to March 31st 2006. The inspection lasted from 10.00am until 2.15pm. Time was spent meeting the manager and going through various records and documentation. About one and a half hours was spent meeting service users. Four staff on duty were spoken with. A partial tour of the premises was undertaken. Due to the nature of the service, it is difficult to reliably incorporate accurate reflections of the service users in the report. Some judgements about quality of life and choices were taken from direct conversation with service users and observation followed by discussions with staff and evidencing from records held in the home What the service does well: What has improved since the last inspection? The home has almost completed the things identified for improvement during the last inspection. The manager has successfully gone through the process of becoming the registered manager with the CSCI. There has been an increase in the activities on offer. The kitchen has been awarded a bronze award from the environmental health officer. .The Hollies Rest Home H56-H06 S24029 The Hollies Rest Home V226934 210605 Stage 4.doc Version 1.30 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 Rest Home H56-H06 S24029 The Hollies Rest Home V226934 210605 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 Rest Home H56-H06 S24029 The Hollies Rest Home V226934 210605 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) 3, 4, 6. Service users can feel confident that their needs will be fully assessed and met in the home. EVIDENCE: A visiting professional described how the home conduct excellent assessments to ensure that they are able to fully meet the needs of service users prior to admitting them. Joint health and social care assessments are conducted. For service users admitted from hospital assessments are completed during their stay as an inpatient. Relatives spoken with described how they viewed other homes before choosing the Hollies; that they had a brochure; statement of purpose and service users guide. Their only negative comment was that they would have liked to have had a meeting with the key worker as part of the assessment process. Overall they felt that the transition into the home had been managed well. They were visiting today with the specialist care manager for the 4 weekly review of care. The care manager stated that she had also reviewed after a week. Copies of assessments are kept in files, these assessments form part of the overall care plan. A service user spoken with said they had come from hospital. The home does not provide intermediate care. .The Hollies Rest Home H56-H06 S24029 The Hollies Rest Home V226934 210605 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, 9, 10 Service users general health and well-being is met at the home. EVIDENCE: Comprehensive care plans are maintained for each service user. They were informative and detailed. During the inspection a review of care was taking place, relatives were included in this process. The accident records were inspected and contained minor falls and injuries. Notifications of incidents have been forwarded to the commission as required. It was noted that some service users feet were swollen and footstalls were not in use. Also that slippers were worn and the weather is hot although the lounge areas were cool. A service user spoken with said they would not keep their feet up. This was discussed at length with the manager, as there is a risk of falling with foot stalls being provided and many of the service users walk around the home and may not be able to negotiate around these. It is recommended that advice be sought for individual service users who have swollen feet from the appropriate health professional i.e. district nurse and consideration be made as to the seating arrangements and environment if foot stalls are recommended. A service user said, “I had my eyes done yesterday” and when asked about a dentist replied, “Someone comes to see me”. District nurses were visiting during the inspection and were taken to their rooms to be .The Hollies Rest Home H56-H06 S24029 The Hollies Rest Home V226934 210605 Stage 4.doc Version 1.30 Page 10 seen in private. The hairdresser currently uses the room / area by the staff office. The medication continues to be stored in a cupboard with no ventilation. Medication is now on a shelf and off the floor. During the inspection the morning medication was still being administered. The mar charts were accurately recorded and staff spoken with was familiar with the medication being given and the possible side effects. The PRN medication requires to have some guidance written from the GP as to when and why this should be given. It was agreed with the manager that the pharmacy inspector would be asked to visit the home to give advice and guidance as to the current arrangements with the medication. Staff were observed to adhere to good practice when entering service users rooms. .The Hollies Rest Home H56-H06 S24029 The Hollies Rest Home V226934 210605 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, 15. Service users have a relaxed comfortable lifestyle and the pleasure of home cooked meals and snacks. EVIDENCE: Service users were seen during the inspection to wander freely around the home and staff were observed to anticipate and offer support i.e. with escorting to the toilet or gently persuading a service user to sit in a more comfortable seat. Service users appeared happy, relaxed and comfortable, sitting and chatting with each other and dancing and singling to music. Staff were very familiar with the service users individual preferences and were able to inform the inspector of their likes. The interaction between staff and the service users was very good and respectful on a mutual basis, both sharing smiles and laughter. The home has a designated staff member that spends 3 hours in the afternoon doing activities. Another activity co coordinator visits the home weekly. There are 2 cats who were very tame and curled up either on the sofa of service users laps. Sensory equipment was seen around the home. A service user spoken with said “I go to bed when I like, I ask staff and they take me”, they also commented that they “play ball sometime”. Another service user commented how much they liked the music and said, “Yes I think I’m comfortable”. The food is fresh and home cooked with traditional meals prepared. A service user said that rice pudding was their favourite and that they had good meals with supper. In the kitchen there was plenty of food available, with gypsy tart, cakes and special jam tarts for those service user .The Hollies Rest Home H56-H06 S24029 The Hollies Rest Home V226934 210605 Stage 4.doc Version 1.30 Page 12 who were diabetics. There was a choice of meal available, the cook described how service users through them being offered the selection for the day chose them. Special diets are catered for. As with previous inspections the food was appetising, nutritious and a lot of thought had gone into ensuring that the menu catered for the service users tastes. Relatives spoken with said that their relative rang them from the home and they were able to visit anytime. .The Hollies Rest Home H56-H06 S24029 The Hollies Rest Home V226934 210605 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, 18. Service users can feel safe in the home and secure in the knowledge that staff would take the appropriate measures to ensure this. EVIDENCE: No complaints have been made. The complaints file contained a record of old complaints. Throughout the inspection none of the service users were heard to complain or their actions indicate that they were either unhappy or in any distress. The home have had 1 adult protection alert raised that was managed very promptly and efficiently by the home evidencing good practice and a high standard of care. The manager has consulted the inspector with any areas of concerns for guidance and advice and regulation 37 notifications have been received as appropriate. .The Hollies Rest Home H56-H06 S24029 The Hollies Rest Home V226934 210605 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, 20, 21, 22, 26. Overall the service users live in comfortable surroundings and can make the most of the space provided in the lounges, dinning areas and conservatory. EVIDENCE: During the tour of the premises the home was seen to be in a state of good repair. The gardener was busy mowing the lawn and the gardens were well tended. The manager stated that the fire officer was booked to visit that afternoon and she was going to discuss the measures taken to ensure the safe use of the doors. The home has three rooms used for dinning areas. Some service users were finishing off eating their breakfast in the lounge area. The lounges were comfortable. The conservatory is used for extra space. Service users were seated in various areas and wandered around freely changing seats. One service user in the lounge commented “Isn’t it nice in here, cool”. The manager stated that quotes were currently being sought for a basin to be fitted in the communal toilet and that the home were still considering replacing the bath that is not used with a shower. The double rooms had call bells fitted although the cord had not yet been put in place, the manager explained that .The Hollies Rest Home H56-H06 S24029 The Hollies Rest Home V226934 210605 Stage 4.doc Version 1.30 Page 15 the handy person had fitted these and they were waiting for the leads to be installed. The laundry room is small and compact. Red laundry bags were seen to be in use and staffs were wearing protective aprons. The kitchen has been awarded a bronze award from the environmental health officer. The recommendation of having a commode and sluicing facility in closer proximity to the bedrooms on the upper floor was discussed. Due to the lack of rooms available this may be difficult. The manager was advised to contact the environmental health officer to seek advice in order to consider the options fully. .The Hollies Rest Home H56-H06 S24029 The Hollies Rest Home V226934 210605 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. The home provides a range of staff to meet the needs of the service users. EVIDENCE: A copy of the duty rota was inspected it did not contain a detail of the capacity of staff, the exact hours worked or everyone that was working i.e. the activity coordinator. Staff on duty today included 5 care staff, the manager, a cook and kitchen assistant and a gardener doing the mowing and domestic staff. The manager explained that they were advertising for local care staff and a laundry person, currently staff undertake extra shifts to cover this. During the inspection a perspective staff telephoned for an application form. Relative spoken with commented the “Staff here are very friendly”, service users comments included “Staff not bad one staff get my things for me today”, “I’m happy enough here, I like the boss Rosie”, “I got a key worker, always asks me what I want”. Currently the home has 50 of staff with NVQ level 2 or equivalent. .The Hollies Rest Home H56-H06 S24029 The Hollies Rest Home V226934 210605 Stage 4.doc Version 1.30 Page 17 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, 36, 37, 38. Service users benefit from a well managed home with a pleasant welcoming atmosphere and staff who are given clear direction and leadership. EVIDENCE: The manager has successfully completed her interview to become registered with the CSCI. She has been acting in the capacity of manager for over a year and has been working in the care field for over 9 years. The home has a management structure that consists of the manager, then senior carers who run the shifts. The out of hours on call is undertaken by the manager, which effectively leaves her responsible for 24 hours every day. It is very strongly recommended that this be reviewed with the responsible individual. During the inspection all staff spoken with were open and happy to discuss things with the inspector. The manager had numerous visitors and meetings during the inspection. Staff frequently referred to the manager to keep her informed and seek advice or guidance. The inspector received copies of the results of the quality assurance survey .The Hollies Rest Home H56-H06 S24029 The Hollies Rest Home V226934 210605 Stage 4.doc Version 1.30 Page 18 Service users were familiar with staff and the atmosphere generated by the interactions between staff and service users was positive; warm; friendly and encouraging. A service user spoke of how the manager helps with her money. A care plan review notes conducted by a care manager stated their appointee-managed finances. Records of regular supervision dates were seen. Staff confirmed supervision takes place. All of the records were seen to be kept secure and as far as it is reasonably practicable to ascertain accurate and up to date. The fire officer was stated to be visiting that afternoon, providing the opportunity for the manager to discuss the precautions against the risk of fire of combustible items stored. .The Hollies Rest Home H56-H06 S24029 The Hollies Rest Home V226934 210605 Stage 4.doc Version 1.30 Page 19 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 4 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 1 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION 2 3 2 3 x x x 2 STAFFING Standard No Score 27 2 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 2 3 x x x 3 3 2 .The Hollies Rest Home H56-H06 S24029 The Hollies Rest Home V226934 210605 Stage 4.doc Version 1.30 Page 20 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 OP 9 Regulation 13 (2) Requirement The registered person shall ensure that the care home is conducted as to promote and make proper provision for the health and welfare of service users and making arrangements for the recording, handling, safekeeping, safe administration of medicines. As identified in the text. The registered person shall ensure that all part of the home to which service users have access are so far as reasonably practacable free from the hazards to their safety in that measures must be taken to ensure the safe use of the doors leading to bedrooms 7 and 7A and bedrooms 8 and 9. The registered perosn shall maintian in the care home a copy of the duty roster of persons working at the care home, and a record of whether the roster was actually worked. The registered person shall after consultation with the fire authority take adequate Timescale for action The areas that the home are able to address without further advice should be forwarded to the CSCI. Advice sought and acted upon from fire officer. 2. OP 19 13 (4) (a) 3. OP 27 17 (2) Schedule 4 22nd June 2005 4. OP 38 23 (4) (a) 22nd June 2005 Page 21 .The Hollies Rest Home H56-H06 S24029 The Hollies Rest Home V226934 210605 Stage 4.doc Version 1.30 precautions against the risk of fire in that combustible items be stored safely. 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 OP 8 Good Practice Recommendations It is recommended that advice be sought in regard to measures to reduce the swelling that occurs in the feet and lower legs. It is recommended that during the hot weather attention is made to the cloths and type of footwear i.e. loose cool clothing and perhaps sandals. It is strongly recommended that the communal toilet on the first floor is equiped with a hand wash basin. It is strongly recommended that commode washing facilities are provided in closer proximity bedrooms on the upper floor. It is very strongly recommended that the responsible individual review the out of hours on call system. 2. 3. 4. OP 21 OP 26 OP 31.7 .The Hollies Rest Home H56-H06 S24029 The Hollies Rest Home V226934 210605 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection The Oast, Hermitage Court Hermitage Lane Maidstone Kent ME16 9NT 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 Rest Home H56-H06 S24029 The Hollies Rest Home V226934 210605 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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