Care Home: Hollins Park Nursing Home

What the care home does well People that use services live in a welcoming and comfortable homelike care home, which has been improved to offer better living standards. Flooring in the corridors and dining areas has also been replaced. The four small kitchens have been redecorated and new kitchen units and equipment provided. The home has had new dining furniture bought and offers quieter areas in which to sit as well as dining space so people that use services have more choice where they spend their day and free time. People that live at the home made positive comments about living at Hollins Park and said, "I love living here, I live with a lot of lovely people and we are very friendly and get on well. I know how to make a complaint and don`t have any about living here as I`m happy". The home provides staff with a training programme so staff were provided with training and support to do their jobs. There is a stable staff group who have positive attitudes to the people that live there so staff treat people with dignity and respect. Appropriate staffing levels are provided so people that use services were supported around their needs. The personal care and health needs of people that use services are met to a good standard so they are supported to maintain their personal appearance and hygiene. Visitors are made welcome and a visitor`s comments support this A varied menu is available so people that use services can choose different meals and have a cooked breakfast if they wish. Regular health and safety checks of the building are carried out as well as continued programme of redecoration and purchasing of furniture and equipment so people that use services live in a safe and well maintained building. What has improved since the last inspection? The decoration of the building and bedrooms of people living at the home has made the home brighter so people that use services live in a more welcoming home. The purchase of new furniture and replacement of flooring has improved the comfort of the home so people that use services have a more comfortable place to live. Signs put up in the home to help people living the home recognise their bedrooms, toilets and bathrooms have improved so people can recognise their surroundings more easily. What the care home could do better: The home should gather as much information as possible about all areas of peoples` lives of people that use services so they can decide if the home can provide the right care to meet their needs. The home should should improve how decisions about daily living made by people that use services are reflected in their care plans so staff and others involved in their care understand how important peoples` daily decisions about their lives and decisions about their future are to them so the agreements about how they make or aresupported to make decisions are clearly understood. The home should use communication plans to guide staff about how people that use services communicate their needs so staff can understand and support people that use services to tell them what they want. Staff should not administer medicines to people that use services at busy times of the day so they are not disrupted or distracted leading to mistakes in medicine administration. People that use services should be provided with more opportunities to be involved in recreational and social activities of their choice so they can live fulfilling lives. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Hollins Park Nursing Home Victoria Road Macclesfield Cheshire SK10 3JA     The quality rating for this care home is:   two star good 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: Anthony Cliffe     Date: 2 2 0 6 2 0 0 9 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. that people have said are important to them: They reflect the things 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 Older People 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 Older People Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Hollins Park Nursing Home Victoria Road Macclesfield Cheshire SK10 3JA 01625503028 01625503031 manager.hollinspark@careuk.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Community Health Services Limited care home 49 Number of places (if applicable): Under 65 Over 65 0 dementia Additional conditions: 49 The registered person may provide the following category of service only: Care home with Nursing - Code N. To service users of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Dementia Code DE. The maximum number of service users who can be accommodated are: 49. Date of last inspection Brief description of the care home Hollins Park provides nursing care for 49 people living with dementia. The building is a detached two-storey property situated in its own grounds near Macclesfield District General Hospital. It is approximately one mile from Macclesfield town centre. A car park is provided for visitors, and a local bus service runs close to the home for people reliant on public transport. The accommodation is laid out in four wings on two floors with 33 single and 8 double bedrooms. Each wing has a lounge, dining room and smaller lounge. There is passenger lift access to the first floor. The weekly fee payable at the home range from five hundred and seventy five pounds Care Homes for Older People Page 4 of 30 Brief description of the care home to six hundred and forty two pounds per week. Information about Hollins Park can be obtained by contacting the home directly. Care Homes for Older People Page 5 of 30 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: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: References to we, our or us represent the Care Quality Commission This unannounced visit took place on the 22nd June 2009 and lasted seven hours. One inspector carried out the visit. This visit was just one part of the inspection. Other information received was also looked at. Some weeks before the visit the manager was asked to complete a questionnaire called an Annual Quality Assurance Assessment (AQAA) telling us what they thought they did well, what they needed to do better and what they had improved upon since the last visit, to provide us with up to date information about the services provided. This helps us to decide if the management of the home see the service they Care Homes for Older People Page 6 of 30 provide in the same way we do and if our judgements are consistent with home owners or managers. During the visit various records and the premises were looked at. People that use services, a relative, staff and the deputy manager were spoken with and gave their views about the service. We provided questionnaires to people using the service, staff and health and social care professionals involved in their care so they can tell us their views about the service the home provides. In July 2008 we did an annual service review of the home, which told us the home was still providing a good service. An annual service review is a summary of our knowledge about how a service that has not had a visit in the last year is still performing. It is also how we decide if a service is still as good as we thought it was since out last visit or annual service review. What the care home does well: What has improved since the last inspection? What they could do better: The home should gather as much information as possible about all areas of peoples lives of people that use services so they can decide if the home can provide the right care to meet their needs. The home should should improve how decisions about daily living made by people that use services are reflected in their care plans so staff and others involved in their care understand how important peoples daily decisions about their lives and decisions about their future are to them so the agreements about how they make or are Care Homes for Older People Page 8 of 30 supported to make decisions are clearly understood. The home should use communication plans to guide staff about how people that use services communicate their needs so staff can understand and support people that use services to tell them what they want. Staff should not administer medicines to people that use services at busy times of the day so they are not disrupted or distracted leading to mistakes in medicine administration. People that use services should be provided with more opportunities to be involved in recreational and social activities of their choice so they can live fulfilling lives. 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 30 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 30 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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. Information is provided to people that use services about Hollins Park so they can decide if the home is suitable to meet their needs. Information gathered about the needs of people moving to live there needs to be developed further to help staff decide if the home can provide the right care to meet peoples needs. Evidence: We saw that the home provides information to people that use services in an information pack. The pack contained information about the facilities and services available at the home as well as how care could be arranged. This meant that people choosing a home could decide if their needs could be met at Hollins Park. This information is called the service user guide. The pack also contained information about the type of needs the home could care for and how arrangements were made for people to move in. This was to help make sure that staff could provide the right type of care for people living there. This information was called the statement of purpose. Care Homes for Older People Page 11 of 30 Evidence: The information pack also contained details about the organisation that owned the home as well as information about meals and activities available so people choosing a home had other useful information to help them make a decision about living there. People choosing a care home are encouraged to visit the home and can have a 4 week trial period so they can decide if they want to live there and see whether the home meets their expectations. We could see that before people moved into the home information was gathered about their needs so they could decide if the home was right for them. This process included involving the person themselves where possible, relatives and others with an interest in their care. This helped to make sure that as much information as possible could be provided on which to make decisions about the persons care. The information we saw that had been gathered about people before they moved into the home did not include information about their routines and lifestyles. There was information about their social interests and hobbies, medical information on their physical and mental health, how they communicated with people, maintaining their safety, managing finances, help with personal care, and their life histories so staff had information about the people they cared for and supported. This process included gathering information from health and social care professionals so staff were aware of the health and social needs of people they were asked to provide care and support for. Care Homes for Older People Page 12 of 30 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported so they are safe and well but are not always involved in everyday decisions or decisions about their care. Arrangements for administering medicines to people living at Hollins Park need to be improved so staff are able to do this safely. Evidence: We saw that information was gathered about the needs of people who move into the home so staff had guidance to provide support and care. We could see some examples that there is a person centred approach to care used at the home but staff do not use person centred thinking and planning to make sure that the care provided is always based around peoples needs and choices. Person centred planning is a really good way for people that use services to take control of their lives. Person centred thinking helps staff who provide care and support to listen to the people they are caring for so the care is provided as they need in the way they prefer. A person centred plan contains information on what is positive about people; for example, what people like and admire about them and their gifts and talents. Information should be included Care Homes for Older People Page 13 of 30 Evidence: about what and who is important to people from their viewpoint, as well as what people want for their future. A person centred plan should have information about how people want to be supported to stay healthy, safe and well. This is called a support plan but may be called a care plan. It should be detailed enough to provide a living description of how people that use services want to be supported, how they make decisions and says who will do what by when. The information the manager sent to us before our visit said that personal care is person led and decided at the pace of the person receiving it. Care plans were said to be individual to people using the service and included personal routines and choices about personal care. The care plans we saw said some positive things about how people could help themselves but did not tell us how people wanted their care to be arranged and how staff would provide support or care to help them to care for themselves or if care was arranged or planned around their daily routines. So care based on their personal preferences was not always provided, for example, for routines around personal care and bathing. The care plans did provide staff with some guidance on supporting people to remain independent by encouraging them to attend to their personal care and saying how people helped themselves. The homes staff have been gathering information about the life histories of people living there but this information was not reflected in the care plans the staff had written to support and provide care for them. This meant that staff did not have information to provide individual care. Care plans did not reflect a person centred approach and contained only a little information on how people could care for themselves or be involved in their personal care. This did not support the claim the home used a person centred approach. We could not see examples of how people that lived at the home chose their daily routines and followed their own lifestyles. Care plans were kept on a computer system and we could not see how the person had been involved in writing their care plan. This means they may not know what was written in their care plans or understand some of the medical words used. We saw that staff treated people living at Hollins Court with courtesy, dignity and respect. They sought their views about how they wanted to be supported and we saw staff help them make decisions. We saw care plans refer to staff making decisions for people living at the home but did not see information about how those people made decisions for themselves. If people living at the home did not make decisions because they lacked capacity, experience or judgement to make them this should be recorded. We could not confirm why, when, where and how staff supported them to make decisions so we were unsure what decisions staff had made for people or supported them to make. Care plans made references to people not being able to make decisions due to their mental health needs or not being able to tell staff what they wanted, so Care Homes for Older People Page 14 of 30 Evidence: staff made decisions for them. We saw people living at the home were given days of the week when they could have a bath or shower, as this information was recorded on the weekly bath list. We saw in care plans that staff were guided to cut a persons nails as short as possible to prevent them from scratching staff when they helped them with personal care. There was no reference as to whether this decision had been agreed with the person or anyone with an interest in their care so their choices were not sought on this decision. We saw that care plans about how people living at the home communicated were used and told staff about the difficulties that people had in making themselves understood or if the had difficulties understanding words or no longer used words due to them living with dementia. We did not see plans that told staff about the individual ways or different methods that people living at the home used to communicate so they could understand them and support them to tell staff what they wanted. Care plans contained important information about the health of people living at the home. An example of this was when information called a nutritional assessment said a person had problems with eating, so a risk assessment and care plan had been written to make sure the persons eating and weight could be watched. This advised staff to weigh the person and make sure she ate her meals as she had lost some weight and needed to be seen by the doctor. It did not tell staff at what point they needed to contact the doctor if more weight was lost. The home had medical cover from local GP surgery so people living at Hollins Park had their health needs looked at regularly. People living at the home have information gathered about how much they eat and drink, how much they weigh, if their skin is in danger of breaking down, their ability to mobilise and walk or if they are in danger of falling as well as their ability to care for themselves. This means staff have information on which to provide care and support. The skin care specialist gives advice to the home when needed and we could see the home only had one person with a pressure ulcer. Psychological services are provided via the local mental health team and the home is able to provide palliative and end of life care. Staff at the home have had end of life care training so they can provide care for people who are dying. Medication policies and procedures were detailed so staff understood their responsibilities and accountability for their actions when giving medicines to people living at the home. Both areas of the home had similar medicine storage facilities and used the same policies and procedures. A medicine fridge was in use with the operational temperatures regularly recorded so staff knew it was operating safely. Each storage area contained the policies and procedures for medicine administration with specimen signatures of staff responsible for administering medicines. We looked Care Homes for Older People Page 15 of 30 Evidence: at the arrangements for the ordering, receipt, administration and disposal of medicines and controlled drugs and found some minor errors. However, people that use services were generally receiving their medicines safely. We talked to staff who were administering medicines about the arrangements for giving out medicines during mid morning. Staff giving out medicines were often disturbed by other staff asking for advice or serving people that use services with breakfast as well as a weekly visit from the doctor. So we could see why errors were made as medicines were being given during this busy time of the day when interruptions meant that staff were not able to concentrate on administering medicines safely. Care Homes for Older People Page 16 of 30 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. 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. People living at Hollins Park are supported to make limited choices and could be offered more opportunities for recreational and social contact so they have control over what they do and lead more fulfilling lives. Evidence: An information board at the main entrance as well as notice boards in the two main areas of the home displayed information about events taking place inside and outside of the home. This also displayed the complaints procedure as well as cards of thanks from relatives. Outside entertainment was provided by visiting entertainers. Local clergy visit the home to speak with people living there and hold regular religious services so they have opportunities to practice their faith. At the time of our visit no activities co-ordinator was employed at the home so there was no one to plan and encourage people to do activities. We saw staff involved in some activities during the day so people that use services had some opportunities for social and recreational contact. We saw some people that use services reading newspapers and magazines, watching TV and listening to music. We saw staff occasionally sitting and talking with people that use services. We saw staff playing Care Homes for Older People Page 17 of 30 Evidence: dominoes and other said they had been playing cards with people that use services. We saw that the communal areas of the home usually had a staff member sat in them so people living at the home had contact with staff. We saw people living at the home sleeping at times so were not engaged in doing anything. Activities were mainly arranged from Tuesday to Thursday. At the time of the visit the main activity taking place was a visit from a hairdresser that visited twice weekly so people that use services could have their hair done. Activities also include exercise, arts and crafts, trips out, gardening, pampering and baking. The home celebrates birthdays and has birthday days for people and has a birthday board so people know whose birthdays they are celebrating. A Fathers day celebration had taken place at the weekend so people had the opportunity to celebrate special occasions. Meals were seen to be varied and supported a balanced diet with advice sought from dietitians where necessary. The menu provided a varied diet and as the home had four separate dining areas, meal times were generally quiet so staff could support people to enjoy their meals without interruption. The food provided was supplied from a catering company and cooked from frozen to provide a varied and nutritional menu which included alternative choices of meals through the day. The menus were displayed on notice boards. The menu covered a four week period and was changed regularly. It was available in a picture format so staff could show it to people living at the home and enable them to choose what they preferred. Breakfast was a choice of cereals, fruit, yogurt and toast. The deputy manager said occasionally the chef made scrambled or boiled eggs. Lunch is the main meal and on the day of our visit was a choice of either lamb casserole or potato and broccoli bake. There was also a choice of two sweets. The evening meal was a choice of a soup, sandwiches and a hot snack. Stocks of cooked meats, cheeses, eggs, fruit, vegetables and a variety of frozen foods are kept in the home so people living there have a choice of other meals. Staff were available to assist people that use services with their meals. Care Homes for Older People Page 18 of 30 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. 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. People living at Hollins Park are protected by the safeguarding adults procedure and staff training in place so they can be confident they are protected at all times. Evidence: We saw that the complaints procedure for Hollins Park was displayed in the entrance to the home as well as laminated and put on notice boards around the home so people had access to it. We looked at the complaints the home had received and complaints received within the twelve months before our visit had been dealt with satisfactorily. Policies and procedures were in place to protect people; these are called the safeguarding adults procedures. The safeguarding adults procedure is how we, the local council, police and other agencies respond to and manage allegations or suspicions of abuse against vulnerable adults. The manager provided training records that showed staff had received training on safeguarding adults. This included training on how to recognise and respond to suspicions of abuse so staff should be able to protect vulnerable adults. Three members of staff we spoke with said they had received safeguarding adults training and described what they would do if they witnessed abuse or neglect or someone reported abuse or neglect to them. This showed us they could respond to suspicions or allegations of abuse or neglect to make sure vulnerable adults were protected. The Care Homes for Older People Page 19 of 30 Evidence: home had a copy of the local authoritys safeguarding adults procedure and had access to the local councils safeguarding adults training programme through the local training consortium. The home had made two safeguarding referrals to the local council since our last visit and had cooperated with the local council in the investigation of these. Care Homes for Older People Page 20 of 30 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, 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. 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. Hollins Park is well maintained so that people living there have comfortable and safe surroundings where their health and safety is promoted. Evidence: We looked around the building and saw improvements in the decoration and furniture had been made through an ongoing redecoration and refurbishment programme. As the home provides care for people living with dementia, more signs and symbols had been added to bedrooms, bathrooms and toilets to help people living in the home find their way to these facilities. Some doors had been personalised with names, photographs or pictures that people living in the room had done so they could easily recognise their own bedroom. Since our last visit, thirty bedrooms had been redecorated and all corridor and dining area flooring has been replaced. All bathrooms have been redecorated and four satellite kitchens refurbished with new kitchen units and equipment. Themed corridor walls had been created to provide a more stimulating environment for people living at the home. This included art and craft work that people living at Hollins Park had done as well as photographs of people using the service being involved in activities. There are plans to continue with the redecoration of the bedrooms so everyone has the same Care Homes for Older People Page 21 of 30 Evidence: living standards. We saw some of the bedrooms and these contained personal effects and furniture. The deputy manager said that people living in the rooms and families had chosen the colour schemes in their bedrooms, so had been involved in the redecoration of the home. The gardens were well maintained and new environmentally friendly garden furniture had been bought so people living at Hollins Park could use the safe and pleasant garden area. Care Homes for Older People Page 22 of 30 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. 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. Good employment procedures and a varied training programme are in place so people that use services are protected by a thorough recruitment process and a skilled staff team. Evidence: We saw the staff numbers in place supported the needs of people living at Hollins Park so they had sufficient help with their needs. The home was not fully occupied and there were sufficient staff to provide care and support for the number of people living there at the time of our visit. Additional staff were on duty to assist with domestic, laundry and catering duties. The manager works at the home five days a week and is not included in the staff on duty so is able to offer support and supervision to the staff team. At the time of our visit the deputy manager was working as part of the staff team due to sickness. The staff induction programme was based on Skills for Care induction standards. These are nationally recognised standards for people who work in social care so staff understand their roles and responsibilities. There are 39 care staff employed at Hollins Park and 61 of these have an national vocational qualification (NVQ) in care at level 2 qualification. These are nationally recognised qualifications for care staff and achievement of them shows that the staff member is competent to provide good Care Homes for Older People Page 23 of 30 Evidence: support and care. Additional care staff are working toward the completion of the NVQ level 2 qualification. We examined the recruitment records of four staff employed at the home. These showed that the recruitment procedures were good and included staff having to complete an application form, full employment history and two references sought about their suitability for employment. The checks carried out also included a Criminal Records Bureau (CRB) disclosure, which is a check of staff to see they are suitable people to provide personal care and support to vulnerable adults. These checks help to make sure that staff are suitable to work with the people who live at Hollins Park. Staff were provided with training which included infection control, safer food handling, safeguarding adults, moving and handling, fire safety, using cleaning materials safely, customer care, managing disturbed behaviour, providing activities, caring for people with dementia, good record keeping, continence promotion and nutrition. This meant that a varied training programme is provided for staff. Senior staff are trained in moving and handling so can provide regular training for staff in helping people move about the home safely. The manager gave us a record of all staff training that had been planned and completed as well as having individual training files so we could see they were provided with regular training to be able to do their jobs. Before our visit staff returned surveys to us that said they received regular support from the manager and training to help them do their jobs. Staff commented that they felt there was a supportive and experienced staff team at the home to care for and encourage people living at the home to care for themselves as much as possible but felt that more staff were needed so individual care could be provided. Care Homes for Older People Page 24 of 30 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. 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. The home is well managed and the quality assurance system being used makes sure that Hollins Park is run in the best interests of the people who live there. Evidence: At the time of our visit the manager was on holiday so the deputy manager was in charge of the home and she was being helped by the administrator. The deputy manager said due to staff sickness she had to work as part of the staff team. The home has an open door policy with the manager, deputy or administrator available to talk or for appointments. This means they are able to listen to concerns. In March 2009 Care UK, the organisation that owns the home, sent out satisfaction surveys to seek the views of people using the service and relatives. There is a suggestion box in the home so people can make suggestions for improvements, compliments or suggestions. A concerns book was kept on each floor so any concerns raised by people living at Hollins Park, relatives or anyone with an interest in their care Care Homes for Older People Page 25 of 30 Evidence: can have their concerns recorded and then passed to the manager. The manager completed checks on a number of things in the home to make sure the home was managed properly. Important information was gathered about the home, how safety was maintained, to check staff were doing their jobs correctly and that people living there were satisfied with the care they received. This was called quality assurance and was carried out by doing lots of checks so the manager could see how everything was working in the home. The managers checks were then checked again by her manager during monthly visits. This meant that Care UK were aware of any matters in the home which needed to be improved upon and could tell the manager if she was doing a good job or needed to make improvements. Managers from Care UK visit Hollins Park every month to do quality assurance checks, talk to people living there and staff and look at important records so they can write a report to say if they think the home is being properly managed. A relative said of the management of the home, I cant praise the place enough. My wife is really settled and she is treated with kindness and care. I think this must be one of the best care homes around. I trust and have confidence in the staff and manager. Im their biggest critic and will always open my mouth if I have something to say. The manager has improved things here. Staff from the home or the company do not act as appointees for any people living at Hollins Park or manage finances on their behalf. Each person living at the home has an account opened for them to deposit money for personal use but they or their relatives may choose not to use this facility so manage their finances themselves. Money was held at the home to pay for chiropody, newspapers, hairdressing and personal items so people using the service could buy things they wanted. Balances were checked against the records held on the computer and the amounts held tallied with the records on the computer so financial procedures were safe. Money held on behalf of people living at the home was checked every month as part of the quality assurance system so there was an independent check of financial procedures. The information we were sent by the home manager before our visit told us that all the required maintenance checks and health and safety checks had been completed as required. This meant that people lived and worked in a safe building. We checked the fire safety checks records and these showed that all the necessary checks had been carried out regularly to make sure the fire safety equipment was working properly. Care Homes for Older People Page 26 of 30 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 Older People Page 27 of 30 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 1 3 Staff from the home should gather as much information as possible about all areas of peoples lives so they can decide if the home can provide the right care to meet the persons needs. The home should use communication plans to guide staff about how people that use services communicate their needs so staff can understand and support people that use services to tell them what they want. Action should be taken to improve how decisions about daily living made by people who live at Hollins Park are reflected in their care plans. This will help staff and others involved in peoples care understand how important peoples daily decisions about their lives are to them so the agreements about how they make or are supported to make decisions are clearly understood. Action should be taken to make sure that staff giving out medicines at busy times of the day are not interrupted or disrupted whilst they are doing this. This will help to make sure that medicines are given out safely as prescribed and will lessen the chance of mistakes being made. People living at Hollins Park should be provided with more opportunities to be involved in recreational and social Page 28 of 30 2 7 3 7 4 9 5 12 Care Homes for Older People activities of their choice so they can live fulfilling lives. Care Homes for Older People Page 29 of 30 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.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 © (2009) 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. 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