Care Home: Hollybank Rest Home

What the care home does well The home has an assessment process which includes inviting potential service users to spend the day at the home, or a number of days. Care plans are in place for all service users and give person centered details about how service users prefer to be supported with their care needs. The home has good links with healthcare professionals and service users access their support when necessary. Medication systems are in place to ensure service users receive their medication as prescribed. Staff respect service users` privacy and dignity. Service users enjoy a range of activities and there is a choice of food at mealtimes. Visitors are welcome in the home. There is a complaints procedure and safeguarding procedures are in place. The providers have made further improvements to the environment since the last inspection. Robust recruitment procedures ensure that new staff do not start work until all the necessary checks are in place. There is a training programme in place and staff told us they particularly enjoyed the Dementia training. There is a new registered manager, who previously worked in the home. The home looks after money on behalf of some service users and records were kept. There is a quality assurance system in place. The home is managed well. What has improved since the last inspection? This was the first key inspection under the current ownership, but ongoing improvements have been made and are detailed elsewhere in this report. What the care home could do better: This report does not identify any areas for improvement. Key inspection report Care homes for older people Name: Address: Hollybank Rest Home 41 Winchester Street Botley Southampton Hants SO30 2EB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Beverley Rand     Date: 1 4 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 23 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 23 Information about the care home Name of care home: Address: Hollybank Rest Home 41 Winchester Street Botley Southampton Hants SO30 2EB 01489784144 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Glynne Pusey and Mrs Emma -Jane Lloyd Pusey Name of registered manager (if applicable) Mrs Christine Few Type of registration: Number of places registered: care home 17 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of people to be accommodated is 17 The registered person may provide the following category of service only: Care Home only (PC) to people of the following gender: Either whose primary needs on admission to the home are within the following category/ies Dementia (DE) Physical Disability (PD) Old age not falling within any other category (OP) Date of last inspection Brief description of the care home Hollybank offers personal care and accommodation for up to 17 people over the age of 65, some of who may have dementia. The home is located in the village of Botley, Care Homes for Older People Page 4 of 23 Over 65 17 17 17 0 0 0 Brief description of the care home which is near Southampton. It has good access to local shops, amenities and public transport. The home has eleven single and three double bedrooms, which are, split over two floors. There is a lift to access the second floor, although some bedrooms are accessed via a short staircase. Communal space includes a large lounge, dining room and an established, accessible and well-tended garden. The current fees are between 535 pounds and 635 pounds a week. Care Homes for Older People Page 5 of 23 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: This was the first unannounced key inspection for this home. The home has been operating for many years but a change of ownership meant that the home had to be re-registered. The manager completed the Annual Quality Assurance Assessment, (AQAA) and returned it to us on time. The AQAA was detailed and gave us the information we asked for. During the inspection we observed how staff interacted with service users, spoke with two staff, the manager and one of the providers. We looked at records such as care plans and recruitment records. Care Homes for Older People Page 6 of 23 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details 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 7 of 23 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 8 of 23 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. The home ensures that service users do not move in unless their needs can be met. Evidence: The home completes an assessment of potential service users needs before they move into the home. The Annual Quality Assurance Assessment, (AQAA) stated that, we have developed a stepping stone approach to moving into the care home so the prospective resident can gain a clear view of the service provided before making a decision. The prospective service user is invited to spend a day at the home at no cost or obligation to them. Another option also available is to come on regular day care basis this can assist the transition of moving into the home. When moving into the home all service users have a months trial period as stated in the service users contract. Care Homes for Older People Page 9 of 23 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. The home ensures that service users health care needs are met, and that privacy and dignity is respected. Good medication systems are in place to protect service users. Evidence: The AQAA stated that, each individual service user has a care plan that is developed with them or a representative/advocate to cover all care needs including physical and social needs. Care plans also give focus to emotional care and aspects around behaviour/Dementia. This care plan is a working document and is up dated monthly or before should a service users needs change. Each individual care plan is in an easy to read format with a picture, this enables people who are not familiar with the individual to be able to deliver a personalised quality service at all times. We looked at three care plans and found that they covered areas such as personal and oral care, continence, skincare, dressing/undressing, foot care, night care, social care, nutrition, communication and medication. Plans were written in a person centered way and identified areas of strength. There were clear guidelines for staff to follow when attending to personal care. There were strategies in place for supporting some service users who may present with challenging behaviour. Each care plan has a form which Care Homes for Older People Page 10 of 23 Evidence: staff can use to write any updates, and the information is then incorporated into the plan. Good daily notes were kept which gave clear detail about how the person had spent their day. The AQAA also referred to healthcare provision: at Hollybank a service user has choice by being able to access outside professionals such as local GPs, nurses and psycho geriatrician which are very supportive as well as a dentistry service for both teeth and dentures, a visiting optician and a chiropodist that visits every 6 weeks. Pressure area care is a high priority and all staff are aware of signs, symptoms and prevention. Continence is promoted with regular offers of assistance. During our visit we saw service users being supported to use the toilet. We saw evidence in records that service users see healthcare professionals when necessary. We were told by the provider that a new electric bed had been bought for a service user whose needs had changed and other equipment was evident. The home has good medication procedures and systems in place. Medication is provided by the pharmacist in blister packs and there is a photograph of the service user on each medication administration record. There were no gaps in the recording of what medication service users had been given and controlled drugs were administered correctly. Staff have received training in the administration of medication and there was a refresher course being provided on the afternoon of the inspection, which all staff were expected to attend. It was evident throughout the inspection that staff and management were respectful of service users privacy and dignity. Care Homes for Older People Page 11 of 23 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. The home ensures that residents enjoy the activities and food, and can make choices about their lives. Visitors are welcomed to the home. Evidence: The home provides weekly social activities, in addition to two shows per month. There is a magazine rack with a varied selection of magazines and reading material, including large print books. Service users are supported to practice their religious beliefs. The home has built raised flower beds for service users to gain easy access to gardening if they wish. An activities schedule is in place each week and includes games, music and movement and reminiscence sessions. Some of the activities are provided by external specialists. There is an activities board in the hallway so that service users can see what is happening in the home. The providers are planning to introduce hand massage for those service users who would like to partake, as they feel it is a good opportunity for staff to interact with service users. The home welcomes visitors, who are welcome to eat a meal with service users. With regard to autonomy, the AQAA states that, service users are fully consulted and are able to exercise choice in all aspects of their lives and have access to Care Aware advocacy service. Care Homes for Older People Page 12 of 23 Evidence: The home employs a cook and there is a choice of food on the menu, which is displayed in the dining room. The home keeps a record of the food eaten by service users and food intake is monitored closely where there are concerns. We saw individual needs being met with regard to offering finger or pureed food, which was variable depending on the service users needs at the time of the meal. Staff showed a knowledge as to what people liked to eat and other individual preferences. We spent some time sitting in the lounge and saw that people were asked whether they would like a coffee or something different and one person not known to the staff was asked if they liked the main dish that day or if they would rather have something else. One service users was asked if they would like another coffee and we were told that this was because this person liked more than one drink. Care Homes for Older People Page 13 of 23 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. The home ensures that residents feel able to complain, and has procedures in place to protect service users from abuse. Evidence: The home has a complaints procedure in place which is explained to new service users. Service users have their own copy. The home has not received any complaints and the provider told us that this is probably because of the transparency with which the home is run and that small issues are sorted out before they turn into complaints. A Safeguarding Adults policy is in place which operates in tandem with the policy and procedure produced by Hampshire County Council designed to protect vulnerable residents from abuse. Staff have received training about adult protection. Staff told us what they would do if they suspected abuse to be happening, and the management were clear on the procedures to follow in the event of this happening. Care Homes for Older People Page 14 of 23 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. Service users live in a clean and homely environment. Evidence: The AQAA provided information about the environment, stating that, Hollybank is an environment that is homely, clean, safe, comfortable and well maintained and has been adapted to meet the needs of the service users. All areas of the home are accessible to service users including the garden. All requirements of the local fire service and environmental health department are adhered to. We provide communal areas inside and out to enable service users to choose to entertain friends and relatives or have some quiet time or join in group activities. Soap, hand cream, facial tissues and paper towels are provided in all lavatories. As well as providing normal adaptations such as raised toilet seats, hoists, grab rails we also provide pressure relieving mattresses on all service users beds as well as air mattresses for the more vulnerable. Service users views are gained when accommodation is re-decorated to suit their likes. During the inspection we saw that improvements have been made since the last inspection. A ramp has been built at the front of the home and most of the windows have been replaced. The home has policies in place regarding hygiene and infection control. All staff have Care Homes for Older People Page 15 of 23 Evidence: their own personal anti- bacterial hand gel and anti- bacterial hand gel is situated throughout the home. There is a separate laundry and staff are provided with protective clothing such as aprons and gloves. Care Homes for Older People Page 16 of 23 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. Service users needs are met by trained staff and there are robust recruitment procedures in place. The home is committed to training and qualifications for staff. Evidence: The AQAA gave us detail about the staffing levels in the home. At least four staff are available in the morning reducing to two in the afternoon and the evening prior to the night staff commencing work and a duty manager on 24hr call as well as proprietors being on 24hr call. These levels do not include the Manager or senior on duty who are supernumary to these numbers during the day. During the inspection, staff appeared unhurried and were able to give individual attention to service users. We looked at the recruitment files for one new staff member and found that the necessary pre-employment checks were in place before the person started work. Care staff undergo a formal induction and the home has a rolling training programme. A training matrix is used to ensure that staff have received the training they need. Training has included health and safety; moving and handling; first aid; food hygiene; medication, fire safety; Mental Capacity Act; Dementia, protection of vulnerable adults; infection control; diet and nutrition and equality and diversity. We spoke to staff about the training and they confirmed training did happen. One said that the Dementia course was, amazing, really good. Care Homes for Older People Page 17 of 23 Evidence: Ten out of eleven care staff have achieved the National Vocational Qualification in care, at level 2 or above. Care Homes for Older People Page 18 of 23 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. Service users live in a well managed home. Evidence: There is a new registered manager at the home. The manager has a National Vocational Qualification in care, level 4 and is looking into undertaking the relevant management course. The manager has worked at the home for many years and therefore knows the home and the service users well. The home looks after money on behalf of some service users. We looked at the records for one service user and found that the records matched the money held. The home has quality assurance systems in place. A survey was completed by service users in July 2009 and the data was analysed. There is a survey available for visitors and healthcare professionals. The provider undertakes monthly visits and writes a report about the visit. Team meetings are held every three or four months and minutes are kept. Care Homes for Older People Page 19 of 23 Evidence: Records were available which showed equipment such as hoists and the lift had been serviced. Fire records were maintained. The home had recently achieved an excellent rating for its Food Hygiene inspection. Care Homes for Older People Page 20 of 23 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 21 of 23 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 22 of 23 Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 23 of 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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