Care Home: Hollybush Care Home

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What the care home does well The staff members at Hollybush provide a good standard of care to the residents that live at the home, they were seen to be treating people with respect and dignity and were able to demonstrate an awareness of their diverse needs. Good relationships were seen to exist between residents, relatives and staff, those people that commented all said that the staff members were good. Comments from residents and relatives included; "the staff members are very good", "the staff are brilliant, I am always made welcome and I have every faith in them". During the visit one of the staff members commented about the change of home manager; "the changeover has been easy". This means that the good service that the home has provided has been maintained without unnecessary disruption. What has improved since the last inspection? Although the new care planning documentation has now been implemented the new manager explained that she had identified some areas within the system that could be improved further. All of the bedrooms in the existing building have been redecorated and recarpeted. New soft furnishings have also been provided. What the care home could do better: Hollybush generally does the majority of things well so rather than state what they could do better we consider that the home needs to continue with the development of the service in order to ensure that the good quality of care provided to the residents at the present time is maintained. CARE HOMES FOR OLDER PEOPLE Hollybush Care Home 101 Lovely Lane Warrington Cheshire WA5 1TY Lead Inspector Paul Ramsden Unannounced Inspection 8th November 2007 09:45 X10015.doc Version 1.40 Page 1 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 Hollybush Care Home DS0000062759.V345632.R01.S.doc Version 5.2 Page 2 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. Hollybush Care Home DS0000062759.V345632.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hollybush Care Home Address 101 Lovely Lane Warrington Cheshire WA5 1TY Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01925 631605 F/P 01925 631605 Mrs Adebunmi Oseni Mrs Joyce Sharp Care Home 15 Category(ies) of Old age, not falling within any other category registration, with number (15) of places Hollybush Care Home DS0000062759.V345632.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 15 service users in the category of OP (Old age, not falling within any other category) 18th December 2006 [Thematic] Date of last inspection Brief Description of the Service: Hollybush is a three-storey privately owned care home for people over 65 years of age. Access between floors is via a shaft lift or the stairs. Residents are accommodated on the ground and first floors only. The home is located in Lovely Lane and is within easy walking distance of a range of local shops and other community facilities. Warrington town centre is a short bus journey away and the home is near Warrington General Hospital. There are adequate car parking facilities available. Residents’ accommodation consists of eleven single bedrooms, and two twin bedded rooms. The home has adequate recreational, dining and communal space available within the building for the number of people that can be accommodated. The current fees for the home are £332 to £347 per week. Further details regarding fees are available from the owner or the manager. Hollybush Care Home DS0000062759.V345632.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit took place on the 11 November 2007 and lasted for six hours. Paul Ramsden, Inspector, undertook the visit on behalf of the Commission for Social Care Inspection. Any references to “we” in the report refer to the Commission. All of the key standards for older people were looked at. Feedback on the findings of the inspection was given to the manager and owner as the inspection progressed. This visit was just one part of the inspection. Prior to the visit the home manager was asked to complete an Annual Quality Assurance Assessment to provide up to date information about the service provided in the home. Questionnaires were made available for residents and families to find out their views and other information received since the last key inspection was reviewed. During the visit various records and the premises were looked at. A number of residents, relatives and staff members were spoken with; they gave their views about the home and the service provided. Since the previous inspection visit the home manager has retired; she had been the manager for a considerable time and will be missed by everyone. As a consequence of this the homeowner has had to appoint a new manager. She is currently undergoing registration with the Commission. A new extension is also being built and at the time of this visit was nearing completion. This will provide an additional eight bedrooms. This will improve the facilities currently available. Everyone was notified before the works started and have been kept fully informed, as the work has progressed. What the service does well: The staff members at Hollybush provide a good standard of care to the residents that live at the home, they were seen to be treating people with respect and dignity and were able to demonstrate an awareness of their diverse needs. Good relationships were seen to exist between residents, relatives and staff, those people that commented all said that the staff members were good. Comments from residents and relatives included; “the staff members are very good”, “the staff are brilliant, I am always made welcome and I have every faith in them”. During the visit one of the staff members commented about the change of home manager; “the changeover has been easy”. This means that the good service that the home has provided has been maintained without unnecessary disruption. Hollybush Care Home DS0000062759.V345632.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Hollybush Care Home DS0000062759.V345632.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Hollybush Care Home DS0000062759.V345632.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information and opportunities to visit before choosing to move in are available and residents are assessed prior to admission to ensure that their needs can be met at the home. EVIDENCE: The home provides a range of information to residents; these include the statement of purpose and the service user guide. The content is good, using plain language and includes enough information to enable the residents to make a choice about whether their needs could be met at the home. These documents contain all of the information required under the Care Homes Regulations 2001 and Standard 1 of the National Minimum Standards for Older People. Although the new manager or the additional eight bedrooms have not been registered yet the documents have been updated to reflect these changes. Hollybush Care Home DS0000062759.V345632.R01.S.doc Version 5.2 Page 9 As part of the inspection process the care files of two people living at the home were looked at. Pre-admission assessments showing that a resident’s individual needs were being assessed in an accurate and consistent way had been carried out. The manager or homeowner usually carries out the assessments. Where applicable the assessment documentation provided by the placing authority was also seen on the files. Residents, relatives and other healthcare professionals are involved with the pre-admission assessment. Intermediate care is not provided at Hollybush. Hollybush Care Home DS0000062759.V345632.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The clients care plans seen provided sufficient information for staff members to be able to take appropriate action to meet an individuals needs. EVIDENCE: The manager or homeowner are responsible for drawing up a resident’s plan of care, the three seen as part of the case tracking process provided staff members with the necessary information for them to look after a person’s diverse needs. The health and well being of residents was being monitored and an appropriate record of development and actions taken was being kept. There was written evidence to confirm that care plans were being reviewed monthly and where necessary re-written. Residents or their families/advocates were seen to be involved in the care planning process. The new care planning system that was in the process of being implemented during the previous inspection visit has now been fully completed. During a discussion with the new manager she explained that there were a couple of areas that she thought could be improved further, this would enable the home to provide a more Hollybush Care Home DS0000062759.V345632.R01.S.doc Version 5.2 Page 11 person centred approach to care which would reflect an individuals needs more accurately. Staff members spoken with had a good understanding of the people they were supporting and were able to meet their diverse needs; they continually monitor the residents’ health needs and there was evidence to show that they were receiving appropriate support from health care professionals. This included GPs, community nurses, optician, dentist and chiropodist. The changing needs of individuals are discussed as and when required. We were able to see this in practice during the visit. It was also seen throughout the visit that residents were being treated with courtesy, respect and good humour by staff. All personal care is carried out in the privacy of a resident’s bedroom or one of the bathrooms. Residents spoken with confirmed that they had been able to express their opinions and wishes about their daily routines. Policies and procedures in relation to medication are in place. Medicines are administered using a blister pack system provided by a local pharmacist. No obvious issues were seen during the inspection visit. The new manager explained that she was going to implement an auditing system for medication. Hollybush Care Home DS0000062759.V345632.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents spoken with were positive about the home and the support they received so they could maintain contact with friends and family and make choices about their daily lives. EVIDENCE: Residents were able to move around freely within the home and a choice of sitting areas was available. They confirmed that routines within the home were flexible and that they were able to make choices in many areas of daily living, for example times of rising and retiring, where to spend their time and with whom and participation in planned activities. Staff members were seen to knock on the door and to await permission before entering a resident’s bedroom. Residents and family members spoken with during the visit confirmed that visitors are free to call at any reasonable time and links with the local community are maintained. Personal mail is given to residents unopened, or given to relatives if appropriate. Meals can be taken in the dining room or in the privacy of residents’ own rooms. The kitchen area was well managed and organised. There is a menu Hollybush Care Home DS0000062759.V345632.R01.S.doc Version 5.2 Page 13 that has the flexibility to meet individual needs and choices. All of the residents that commented said that the food was good and that choices were available. Special diets are prepared where necessary. Hollybush Care Home DS0000062759.V345632.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and relatives are able to complain and action is taken to respond to their concerns. Adult protection training for staff is available to ensure the continued safety of residents. EVIDENCE: There is a clear complaints procedure for the home. This is also included in the Statement of Purpose and Service User Guide. Those residents that commented said that they would inform the home manage or owner of any concerns or complaints. They also said that they felt confident that appropriate action would be taken. Comment slips asking people to comment on the service provided in the home are available in the reception area. The home has not received any complaints since the previous inspection visit. We have received no substantiated complaints about the services provided by the home. The home has an Adult Protection procedure (including Whistle Blowing), which complies with the Public Disclosure Act 1998 and the Department of Health Guidance “No Secrets”. The new manager is aware of the appropriate procedures to follow should an incident arise. The owner and manager confirmed that all staff members have received training in this area. Hollybush Care Home DS0000062759.V345632.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 23, 24, 25 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents live in a safe, homely, clean and comfortable home. EVIDENCE: A tour of the premises was undertaken; this included communal areas and a number of bedrooms. Since the last inspection visit all of the bedrooms in the existing building have been redecorated and re-carpeted. New curtains have also been hung in the bedrooms. Furnishings, fittings and lighting of the communal rooms are of a good quality and are domestic in character. Bedrooms seen during the inspection were personalised, comfortable, wellfurnished and contained items of furniture belonging to residents’. A new extension, created by joining what was the owner’s own house to the rest of the building is currently being built. This will create an additional eight bedrooms and provide additional bathing and lounge facilities. This is almost Hollybush Care Home DS0000062759.V345632.R01.S.doc Version 5.2 Page 16 completed and the Commissions registration team will be visiting the home in the near future. Hollybush has a passenger lift available to allow access between floors. The home also provides adaptations for use by residents with mobility problems. These include bath and toilet aids. The home was found to be clean and tidy on the day of inspection. The laundry is appropriately equipped and good systems are in place for the care of peoples’ clothes. Hollybush Care Home DS0000062759.V345632.R01.S.doc Version 5.2 Page 17 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff members work positively with residents and families to improve the quality of life of people living in the home. A robust staff recruitment process is in place in order to protect residents from possible harm. EVIDENCE: Staff on duty and rotas seen demonstrated that staffing levels and the skill mix of staff is adequate to meet the needs of the residents within the home. Staff members were cheerful and friendly. Residents and the visiting relatives were complimentary about staff attitude and competence. Additional staff members will be needed when the new bedrooms are occupied; this is in hand and new staff rota’s reflecting this change have been drawn up ready for implementation. The staff members working at the home are able to undertake NVQ training, a recognised qualification for staff involved in delivering care. At the time of this visit 12 of the 16 staff members working at the home had achieved this qualification. The staff members spoken with also said that they are able to access a wide range of training courses, these included the courses required under health and Safety regulations such as moving and handling and fire safety as well as other courses such as Dementia care. The new manager is going to undertake an audit of all staff training in order to ensure that it is all up to date. Hollybush Care Home DS0000062759.V345632.R01.S.doc Version 5.2 Page 18 The file for the only recently appointed member of staff seen contained all of the required information and a robust recruitment procedure was in place for the protection of residents. Prospective staff members are checked against the POVA list before employment commences and CRB disclosures are obtained. New staff members are routinely inducted through the home’s induction procedure to ensure that they are suitably trained when starting work. They also undertake Warrington Borough Councils induction scheme. This includes training in fire safety, moving and handling, first aid and food hygiene. This is in line with the Skills for Care Induction Standards. Hollybush Care Home DS0000062759.V345632.R01.S.doc Version 5.2 Page 19 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is being well run and managed on a day-to-day basis. There are appropriate procedures in place to make sure that residents are safe. EVIDENCE: The home has a new manager who is currently undergoing registration with the Commission for Social Care Inspection. She has a considerable amount of experience and was able to demonstrate an awareness of the diverse needs of the residents and how to manage the staff group. She is due to start her NVQ level 4 in the immediate future. A number of positive comments about the new manager were made during the visit. One of the residents said; “she is very gentle and will do everything possible to help people”. Hollybush Care Home DS0000062759.V345632.R01.S.doc Version 5.2 Page 20 Comment slips and a feedback box are located in the entrance area. A quality assurance survey to ascertain whether residents and families are happy with the standards of care being provided is being undertaken. The results will be made available to residents, families and the Commission. Residents’ personal allowances are being handled appropriately. Personal monies were being kept securely and those inspected had correct balances and accurate records. The fire precautions record book was up to date and demonstrated that checks of the alarm system, emergency lighting, fire drills and staff training were taking place at the recommended intervals. There are health and safety policies and procedures in place and there was evidence that staff were receiving training in areas such as moving and handling, first aid and adult protection. The staff members spoken with during the visit confirmed that they attended regular training sessions. Hollybush Care Home DS0000062759.V345632.R01.S.doc Version 5.2 Page 21 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Hollybush Care Home DS0000062759.V345632.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Hollybush Care Home DS0000062759.V345632.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Hollybush Care Home DS0000062759.V345632.R01.S.doc Version 5.2 Page 24 - 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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