Latest Inspection
This is the latest available inspection report for this service, carried out on 1st June 2009. CQC found this care home to be providing an Good service.
The inspector made no statutory requirements on the home as a result of this inspection
and there were no outstanding actions from the previous inspection report.
For extracts, read the latest CQC inspection for Holly Lodge Nursing Home.
Annual service review
Name of Service: Holly Lodge Nursing Home The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection We do an annual service review when there has been no key inspection of the service in the last 12 months. It does not involve a visit to the service but is a summary of new information given to us, or collected by us, since the last key inspection or annual service review.
Has this annual service review changed our opinion of the service?
No You should read the last key inspection report for this service to get a full picture of how well outcomes for the people using the service are being met. The date by which we will do a key inspection: Name of inspector: Suzanne Magnier Date of this annual service review: 0 8 0 6 2 0 0 9 Annual Service Review Page 1 of 7 Information about the service
Address of service: St Catherines Road Frimley Green Surrey GU16 9NP 01252833080 01253833081 Telephone number: Fax number: Email address: Provider web address:
Name of registered provider(s): Name of registered manager (if applicable) Forest Care Ltd Conditions of registration: Category(ies) : dementia old age, not falling within any other category Conditions of registration: The maximum number of service users to be accommodated is 60. The registered person may provide the following category of service only: Care home with nursing (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) Dementia (DE) Have there been any changes in the ownership, management or the Yes service’s registration details in the last 12 months? If yes, what have they been: The registered manager has resigned and the post is currently vacant. Number of places (if applicable): Under 65 Over 65 60 0 0 60 Date of last key inspection: Date of last annual service review (if applicable): Brief description of the service Annual Service Review Page 2 of 7 Holly Lodge is a purpose built nursing and residential home designed to provide nursing care and accommodation to individuals with levels of confusion, mainly with a diagnosis of Alzheimers, and other dementia related conditions. The home is set in its own landscaped gardens, on the outskirts of Frimley Green, and is surrounded by woodland, which creates an atmosphere of peace and tranquillity. The home is privately owned and managed by Forest Care Ltd. The home has been designed over two floors and each floor has a large dining/lounge area with comfortable furnishings including dining tables, chairs and armchairs set in small clusters. There are a variety of rooms available for residents to use which include a well equipped activities room with its own built in sensory room, a family room where residents can meet with their friends and family in private, a doctors room for private consultations, a kitchen to prepare snacks and maintain daily living skills, and a hairdressing salon. Residents bedrooms all include en suite facilities and a call bell system. Residents are encouraged to bring small items of furniture and personal effects in order to help them to feel at home. There are a variety of signs to assist residents when they are moving around the home to orientate themselves and handrails to assist residents with their mobility. The bathrooms and toilets provide specialist equipment to assist residents comfort, independence and safety and the home has a shaft lift which is accessible to all residents in the home. Residents are able to access the enclosed sensory garden and there is ample car parking facilities available. The home has a operations manager and a general nurse in charge of the clinical aspects of the care home. Annual Service Review Page 3 of 7 Service update since the last key inspection or annual service review:
What did we do for this annual service review? We looked at all the information that we have received, or asked for since the last key inspection or annual service review. This included: The annual quality assurance assessment AQAA that was sent to us by the service. The AQAA is a self assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. Surveys had been returned to the commission by staff working at the service and the comments were favourable about the home. Information we have about how the service has managed any complaints. What the service has told us about things that have happened in the service these are called notifications and are a legal requirement. The previous key inspection and the results of any other visits that we have made to the service in the last 12 months and relevant information from other organisations. What has this told us about the service? The home sent us their annual quality assurance assessment when we asked for it. It was clear and gave us all the information we asked for. We looked at the information in the AQAA and our judgement is that the home is still providing a good service. The AQAA advises that an individuals care and support needs are assessed by a suitably qualified member of staff prior to the individuals admission to the home. The assessment forms the persons individual care plan detailing their current needs, the persons likes and dislikes and activities of daily living. The care plans are person centred and tailored to the persons needs and preferences and are reviewed monthly and any necessary changes made. Healthcare services are available to all individuals and peoples psychological health is monitored and mental health referrals via the general practitioner to the Mental Health Team are made when necessary. If an individual requires physiotherapy, nutritional support or the advice of the district nurse then the general practitioner will make arrangements. The home have maintained their professional relationships with outside health care professionals including dentists and opticians who visit on a Domiciliary basis when required. Two chiropodists visit every six weeks and support individuals with specfic health needs for example appointments to the diabetic clinics. The service managers recognise their improvements and have noted in the AQAA that as this is the first full year of trading for Holly Lodge and adjustments have been made to the homes protocols to meet requirements. The care plan system is reported as working well. Annual Service Review Page 4 of 7 The home has two activities coordinators who offer a range of activities to meet the needs of people who are diagnosed with dementia. Activities and facilities include a hairdressing and snooze room and as a result of listenning to individuals the home have on occassions hired a minibus and support some people to the pantomime and the local restaurant for fish and chips. The AQAA advises that feedback suggests that individuals and their relatives are happy with the level of activity available in the home and that the routines of the home are flexible to cater for individual needs and choices. In order to promote peoples equality and diversity the home support individuals to receive spiritual support by receiving communion and encouraging members of the clergy to visit the home. The home have maintained an open door policy and visitors are made welcome by staff. A family room is provided where people can talk privately with their visitors should they not wish to go to their own rooms. The AQAA advises that meals are cooked on the premises using fresh ingredients and are served in either the dining room or the individuals room depending on what the individuals chooses. Through resident meetings and talking with staff people are consulted and encouraged to discuss the menu and request alternatives if required. The home has a formal complaints procedure. The AQAA advises that no complaints have been received by the home within the last 12 months. The home has been subject to one safeguarding vulnerable adult referral of which the commission are informed has been satisfactorily concluded. Individuals living at the home can have access to an Advocacy service that can be used when they do not have any direct relatives who can be responsible for their financial affairs and all individuals are offered the opportunity of a postal vote when appropriate. The home is purpose built and people admitted to the home are encouraged to have their own belongings in their rooms which include pictures, small items of furniture and personal effects in order to make their rooms more familiar and comfortable. Specialist equipment and signage is provided to enable individuals to orientate themselves within the home and retain as much of their independence as possible. The home have a passeenger lift, dedicated activities room,sensory room, kitchen facilities for individuals to use and a family room for private visits and entertainment. The AQAA advises that the garden is accessible and includes a sensory area and is designed with seating areas that include protection from the sun. The AQAA advises that it is hoped that the activities provided by the homes staff will include an active gardening group for those interested. All bathrooms and toilets continue to accommodate wheelchair users and are equipped with grab rails. All corridors are fitted with colour coded handrails for people to use and the home have continued to employ a domestic team whose job it is to keep the home clean and free from any odour. Infection control procedures remain in place to ensure the safety and well being of all people in the home. Recruitment and selection of staff ensures that all appropriate checks are made to make sure that individuals living in the home are protected and safeguarded from any harm or abuse. New staff receive a structured induction training and the home have a planned mandatory training programme and specialised training for example Dementia to make sure that staff are competent in supporting individuals in their care. Five of
Annual Service Review Page 5 of 7 the permanent care staff have achieved their National Vocational Qualification NVQ Level 2 or above. The registered manager post is currently vacant and the commission have been advised that the day to day running of the home is being undertaken by the homes operations manager. The management of the home continues to let the commission know about things that have happened since the last key inspection and they have shown that they have managed issues well. They work well with us and have shown us that their service continues to provide good outcomes for the people who use it. Surveys were sent to the home for distribution by the registered persons yet none were returned to the commission by the date set. The comments received following this annual service review may be kept to inform the next key inspection. What are we going to do as a result of this annual service review? We are not going to change our inspection plan and will do a key inspection by the 30th June 2010, however we can inspect the service at any time if we have concerns about the quality of the service or the safety of the people using the service. Annual Service Review Page 6 of 7 Reader Information
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