Care Home: Hollydale

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What the care home does well We received a good response to our survey and a number of completed questionnaires were returned. We noted that the responses were generally very positive and comments included; `Its great to come to work each day, not only are the service users happy but the staff are too.` `Excellent care provided in an individual way by people who really do care.` `The home feels like a home.` Throughout our visit we observed residents and staff. The residents looked very happy and relaxed in their surroundings and clearly shared good relationships with staff. When asked what he liked about the home one resident pointed to his pec symbol and showed a picture of food, another resident blew a kiss to a staff member when answering the same question. We observed staff going about their duties in a professional and cheerful manner and the atmosphere in the home felt relaxed and happy. We spoke with a numbef of staff members who showed a good understanding of their role and were very positive about the service provided. One staff member said ``I have worked in a lot of different care settings but never one as good as this.`` Another said ``Everything is geared toward the residents and what they want. This is how it should be done and I am honestly proud to work here.` Making a decision as to whether to move to a care home is an extremely important one and it is important that people are provided with a good level of information to help them make an informed choice. The home provides a detailed Service User Guide to all prospective residents and their families which details all aspects of the service provided and other information such as daily routines in the home. The manager has now had this guide made available in a number of formats including pictorial and DVD so that more people have equal access to the information. There is a person centred approach at this home which means that people`s support is planned in line with their individual needs, strengths and wishes. The strong emphasis and creative approach to communication within the home means that people are enabled to express their views to as great an extent as is possible. The level of detail in people`s individual plans means the staff have a good understanding of the support people need and how they want that support to be provided. People`s health care needs are carefully assessed and their ongoing health is carefully monitored. Any health related issues are quickly identified by staff and quick action is taken, such as referral to a health care professional. People`s medication is carefully managed so as to safeguard their health and wellbeing. The lifestyle programme is a major part of the service provided and each person hasan individual lifestyle programme which is developed in line with their own strengths, likes and dislikes. People who don`t want to take part in group activities are provided with one to one opportunities and staff work creatively to ensure that all residents have the opportunity to spend their time in an enjoyable way. There is a good mix of home based and community based activities. There are a number of ways in which residents are enabled to have a say about the running of the home. For example, residents take part in staff interviews and can join the Service User Council which meets regularly to discuss things such as activities or menus. Thought is also given to how people who live at the home are provided with information that is important to them. For example, pictorial rotas are displayed on the notice board so that residents know who is on duty. Residents are provided with pictures of all staff so that they can request to see a certain staff member if they want to. Pictorial menus are used within the home so that residents know the choices available to them each day and can easily point out their preferences. Staff at Hollydale are carefully recruited and well trained. Training is provided in a number of areas to help people carry out their roles well, including sexuality and communication. In addition, all staff are encouraged to obtain National Vocational Qualifications in care at level 2 or above. At the time of our inspection, 18 out of 20 staff members held these qualifications and all senior carers had National Vocational Qualifications at level 3 or 4. The turnover of staff at the home is low which means a good level of consistency for people who live there. Hollydale benefits from strong leadership provided by a highly competent manager with extensive experience. The manager demonstrates a commitment to person centred working and throughout our inspection we saw examples of this put into practice. The manager is provided with regular supervision from the registered provider who also maintains regular contact with residents and staff. The registered provider carries out regular visits during which she explores all aspects of the service provided. What has improved since the last inspection? Following the last key inspection there were some requirements and recommendations made. We were able to determine during this inspection that they had been addressed. One requirement was that staff should receive training in personal relationships and sexuality. We were able to confirm that this training had been provided along with other training in areas such as communication. A requirement was made that recruitment procedures be updated to reflect best practice. We found during this inspection that the home are now following very careful recruitment procedures in the interests of residents` safety and wellbeing.The final requirement following the last inspection was that the manager must ensure that all events which have a significant impact on residents or staff be notified to the Commission. We were able to confirm during this inspection that procedures had been updated to ensure that this now happened in a timely fashion. A recommendation was made following the last inspection that people should be given more opportunity to take part in community based activities. This is an area where significant improvements have been made as detailed later in this report. A recommendation was also made that at least 50% of staff hold National Vocational Qualifications in care at level 2 or above. As detailed later in this report, 18 out of 20 staff members now hold these qualifications. What the care home could do better: There were no requirements made following this inspection. However we did make a small number of recommendations. We made a recommendation that staff personnel files contain clearer information regarding the dates of CRB clearances and references received. This will create a clearer audit trail and make the information easier to access. It will also mean that when CRB forms are destroyed (in line with CRB guidance) the evidence will still be available. Currently residents do have the opportunity to take part in staff recruitment. However, at the moment there are no formal procedures regarding this and it is at the discretion of the manager. We recommended that formal procedures be implemented so that this good practice is continued at all times. We found that residents have some input into staff induction but we suggested that this be developed further. We have made a recommendation that the manager explore how residents could have some meaningful involvement in ongoing staff training and appraisal. We were able to confirm that the majority of staff have received training in the mandatory health and safety areas through discussion with the staff and the manager. However, we recommended that clearer records be kept of the training so that the manager can access the information easily and also ensure that people always receive their refresher training when it is due. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address:     The quality rating for this care home is:   three star excellent 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: Marie Cordingley     Date: 2 2 1 2 2 0 0 8 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 Adults (18-65 years) 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 Adults (18-65 years) Page 2 of 32 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.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 32 Information about the care home Name of care home: Address: Hollydale Back Lane Clayton Le Woods Lancashire PR6 7EU 01772337701 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) : hollydale1@hotmail.co.uk Dalesview Partnership care home 8 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 8 The registered person may provide the following category/ies of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD The maximum number of service users who can be accommodated is: 8 Date of last inspection Brief description of the care home Hollydale is one of three homes situated on the same site. They are owned and managed by the Dalesview Partnership. Hollydale is currently registered to accommodate eight service users with a learning disability and who may also have a physical disability. The home primarily offers long-term care. The home stands in its own grounds and has open views to two sides. The building is a single storey purpose built establishment, with wide doorways and easy access throughout. The home consists of eight single bedrooms, which are all individually furnished, a bathroom and shower room, which have been specifically designed to provide a suitable environment for assisting clients with physical disabilities. There is also a large spacious lounge, dining/activity room and kitchen which clients may access with relevant supervision. In addition there is a laundry and office. There are communal gardens shared by two of Care Homes for Adults (18-65 years) Page 4 of 32 Brief description of the care home the homes. These have been landscaped to the front and side and offer a sensory area. There is also a large patio to the rear. The home is situated in Clayton-le-Woods on the perimeter of a housing estate. There are a range of facilities including a supermarket, library, leisure centre, public houses and park within walking distance which the home accesses. Clayton-le-Woods is situated on the A6 which is the main road linking the city of Preston and the market town of Chorley. This means the service users also have access to the facilities offered in these towns. The basic fee at the home is £750. Care Homes for Adults (18-65 years) Page 5 of 32 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: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating of this service is 3 star. This means that people using the service experience excellent quality outcomes. The inspection included an unannounced site visit which was carried out over one day. During the visit we held discussions with residents, staff and the manager about all aspects of the service. We also viewed a selection of documents including residents individual plans and staff personnel files. We carried out a tour of the home viewing all the communal areas and a selection of residents bedrooms. Prior to our visit we wrote to the manager and asked her to complete a detailed self assessment providing us with a lot of information about how the service is managed. Care Homes for Adults (18-65 years) Page 6 of 32 The self assessment also asked the manager to identify particular strengths of the service and areas for development. We wrote to residents of the home and staff members and asked them to take part in a survey. We received a good response to the survey. During our visit we carried out a case tracking exercise. This involves us looking very closely at all the care provided to a small number of residents from the point of their admission to the home. What the care home does well: We received a good response to our survey and a number of completed questionnaires were returned. We noted that the responses were generally very positive and comments included; Its great to come to work each day, not only are the service users happy but the staff are too. Excellent care provided in an individual way by people who really do care. The home feels like a home. Throughout our visit we observed residents and staff. The residents looked very happy and relaxed in their surroundings and clearly shared good relationships with staff. When asked what he liked about the home one resident pointed to his pec symbol and showed a picture of food, another resident blew a kiss to a staff member when answering the same question. We observed staff going about their duties in a professional and cheerful manner and the atmosphere in the home felt relaxed and happy. We spoke with a numbef of staff members who showed a good understanding of their role and were very positive about the service provided. One staff member said I have worked in a lot of different care settings but never one as good as this. Another said Everything is geared toward the residents and what they want. This is how it should be done and I am honestly proud to work here. Making a decision as to whether to move to a care home is an extremely important one and it is important that people are provided with a good level of information to help them make an informed choice. The home provides a detailed Service User Guide to all prospective residents and their families which details all aspects of the service provided and other information such as daily routines in the home. The manager has now had this guide made available in a number of formats including pictorial and DVD so that more people have equal access to the information. There is a person centred approach at this home which means that peoples support is planned in line with their individual needs, strengths and wishes. The strong emphasis and creative approach to communication within the home means that people are enabled to express their views to as great an extent as is possible. The level of detail in peoples individual plans means the staff have a good understanding of the support people need and how they want that support to be provided. Peoples health care needs are carefully assessed and their ongoing health is carefully monitored. Any health related issues are quickly identified by staff and quick action is taken, such as referral to a health care professional. Peoples medication is carefully managed so as to safeguard their health and wellbeing. The lifestyle programme is a major part of the service provided and each person has Care Homes for Adults (18-65 years) Page 8 of 32 an individual lifestyle programme which is developed in line with their own strengths, likes and dislikes. People who dont want to take part in group activities are provided with one to one opportunities and staff work creatively to ensure that all residents have the opportunity to spend their time in an enjoyable way. There is a good mix of home based and community based activities. There are a number of ways in which residents are enabled to have a say about the running of the home. For example, residents take part in staff interviews and can join the Service User Council which meets regularly to discuss things such as activities or menus. Thought is also given to how people who live at the home are provided with information that is important to them. For example, pictorial rotas are displayed on the notice board so that residents know who is on duty. Residents are provided with pictures of all staff so that they can request to see a certain staff member if they want to. Pictorial menus are used within the home so that residents know the choices available to them each day and can easily point out their preferences. Staff at Hollydale are carefully recruited and well trained. Training is provided in a number of areas to help people carry out their roles well, including sexuality and communication. In addition, all staff are encouraged to obtain National Vocational Qualifications in care at level 2 or above. At the time of our inspection, 18 out of 20 staff members held these qualifications and all senior carers had National Vocational Qualifications at level 3 or 4. The turnover of staff at the home is low which means a good level of consistency for people who live there. Hollydale benefits from strong leadership provided by a highly competent manager with extensive experience. The manager demonstrates a commitment to person centred working and throughout our inspection we saw examples of this put into practice. The manager is provided with regular supervision from the registered provider who also maintains regular contact with residents and staff. The registered provider carries out regular visits during which she explores all aspects of the service provided. What has improved since the last inspection? Following the last key inspection there were some requirements and recommendations made. We were able to determine during this inspection that they had been addressed. One requirement was that staff should receive training in personal relationships and sexuality. We were able to confirm that this training had been provided along with other training in areas such as communication. A requirement was made that recruitment procedures be updated to reflect best practice. We found during this inspection that the home are now following very careful recruitment procedures in the interests of residents safety and wellbeing. Care Homes for Adults (18-65 years) Page 9 of 32 The final requirement following the last inspection was that the manager must ensure that all events which have a significant impact on residents or staff be notified to the Commission. We were able to confirm during this inspection that procedures had been updated to ensure that this now happened in a timely fashion. A recommendation was made following the last inspection that people should be given more opportunity to take part in community based activities. This is an area where significant improvements have been made as detailed later in this report. A recommendation was also made that at least 50 of staff hold National Vocational Qualifications in care at level 2 or above. As detailed later in this report, 18 out of 20 staff members now hold these qualifications. 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 Care Homes for Adults (18-65 years) Page 10 of 32 240 7535. Care Homes for Adults (18-65 years) Page 11 of 32 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 12 of 32 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes thorough and sensitive assessment process means that people can be confident that they will receive the support they need as soon as they move into the home. Evidence: People who are considering a move to the home are provided with a good amount of accessible information to help them make their decision. This includes a Service User Guide that gives information about the service provided and daily routines within the home. The Service User Guide is available in a number of formats including a DVD for people who are not able to access written information. In addition there is an accessible website for people to view. Information on the website includes all the policies and procedures that the home has in place. During this visit we were unable to track the care of a recently admitted resident because the last admission to the home was made over four years ago. However, from Care Homes for Adults (18-65 years) Page 13 of 32 Evidence: our case tracking process and through discussion with the manager and staff, we were able to confirm that carers have a very good understanding of individual residents needs. We looked at the written procedures followed by the home during the assessment and admission process and found that these were very thorough. The assessment process includes a period of several months during which the prospective resident is encouraged to regularly visit the home, firstly for short periods and further on in the process, for overnight stays. The thorough approach to assessment means that by the time a resident is admitted to the home, carers gave a good understanding of their support needs and can plan their care effectively. It was also pleasing to note that during previous admissions, the home had arranged for some prospective residents to access independent advocacy support to ensure that their opinions and views were central to the assessment process. Care Homes for Adults (18-65 years) Page 14 of 32 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are encouraged to direct how their care is provided and to have a say about the running of the home. Evidence: We viewed a number of residents individual plans and found these to be of an excellent standard. The plans we viewed covered all aspects of peoples daily lives and contained detailed guidance as to how people would like their support to be provided. We found evidence that the home use a variety of creative methods to ensure that people are fully involved in the development of their own plans and each persons plan included very detailed information about their preferred methods of communication. This means that residents have the opportunity to say what is important to them and how they would like their care to be provided. In addition, we noted that peoples plans were produced in a pictorial format making the information in them more accessible and meaningful. Care Homes for Adults (18-65 years) Page 15 of 32 Evidence: All residents at the home have access to independent advocates. Advocates are specially trained to support people who may need assistance to express their views and opinions. Where appropriate, advocates had been involved in the development of residents care plans to ensure that they were in line with peoples individual needs and wishes. In discussion, the manager demonstrated that she has a positive approach to risk taking and she was able to provide examples of situations where residents had been supported in a positive manner, to take well managed risks, thus enhancing their personal development. We viewed a number of risk assessments that had been carried out and found these to be of a good standard, taking into account all the relevant information and providing clear guidance to staff in how to support people safely. We found that there were a number of ways in which residents can be involved in the running of the home including the Service User Council. We saw example of changes that had been made as a result of requests or suggestions from the Service User Council including the provision of new garden furniture. Care Homes for Adults (18-65 years) Page 16 of 32 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to spend their time doing things they enjoy both at home and in their local community. Evidence: Across the Dalesview Group of homes there is a strong emphasis on providing people with opportunities to enhance their lifestyle by spending time in enjoyable and fulfilling ways, maintaining existing skills and hobbies and developing new ones. A number of people who responded to our written survey commented on the provision of activities as being a particular strength of the home. One staff member wrote Every person has a person centred lifestyle programme which includes drama, music, arts and craft and beauty therapy to name but a few. Care Homes for Adults (18-65 years) Page 17 of 32 Evidence: When we viewed peoples individual plans we saw that their individual preferences in relation to how they spent their time had been explored and a personalised lifestyle programme had been developed using this information. Some people who live at the home prefer not to take part in group activities and this was reflected in their individual plans. Details of the one to one activities they enjoyed with staff were clearly stated as was evidence that these activities were offered on a regular basis. It was also evident that there was an innovative approach to enhancing peoples daily experiences. All staff are trained in intensive interaction which is a therapy designed to benefit those people with profound disabilities. It involves gently interacting with someone in their own way and in a way they find enjoyable. Activities regularly provided include those held within the home, and over recent years efforts have been made to increase peoples opportunities to access facilities and develop relationships in the local community. Each person has a community presence plan that outlines their support needs to access the community and the links that they have made. For example, one resident had befriended staff at a local garden centre and regularly spends time there, another has joined a local golf club. All residents at the home have the opportunity to take part in at least one holiday each year. Work has been done to ensure that holidays are person centred and in line with peoples individual preferences. For example, one resident had recently been on an Abba tribute holiday as she was fan of the group. Menus show that people are offered a varied and nutritious diet and in discussion, the manager advised us that residents were involved in the development of menus where possible. It was pleasing to see that pictorial menus had been developed to help residents choose what they would like to eat each day. We saw a resident being shown pictures of various snacks available and being supported to point out the one he would like. We tracked the care of one resident who had complex dietary needs and found that his individual plan was very clear about the support he needed in this area. The resident had been referred to a number of specialists including a speech therapist and dietitian. Clear guidelines were in place to help staff support him safely. We were also able to confirm that when the resident has experienced some weight loss, this has been identified very quickly by staff who had taken quick action and accessed medical advice. Care Homes for Adults (18-65 years) Page 18 of 32 Evidence: Care Homes for Adults (18-65 years) Page 19 of 32 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from effective, well managed health care support. Careful systems used by the home when dealing with peoples medication help to safeguard peoples health and wellbeing. Evidence: We viewed several residents individual support plans and found that they were very comprehensive in terms of the daily support required by each person. The plans were based on residents strengths and goals and demonstrated that people had been involved in the development of their own plan. The level of information included in residents individual plans would enable people to provide support which was individually tailored to the person. For example, one persons plan said When helping me to get out of bed in the morning give me lots of time and encourage me to take it very slowly as my joints can be stiff. Peoples individual plans included a strong emphasis on promoting independence, choice and dignity. Where people were able to carry out certain tasks for themselves Care Homes for Adults (18-65 years) Page 20 of 32 Evidence: this was clearly detailed and staff were guided to support people to maintain their independence. Each persons individual plan included comprehensive health information. Peoples health action plans included details of their specific care needs and areas such as optical and dental care. We saw evidence that people living at the home are supported to access specialist services when they require them such as community health care. In addition there are specialists employed within the home including speech therapists and dietitians, to ensure that people have immediate access to these services should they need them. The home had an inspection by a specialist pharmacist inspector in October 2008. The inspector found that the home had very good systems in place to ensure that peoples medicines were safely managed. Following the inspection some recommendations were made to further improve the area and we were able to confirm during this visit that these recommendations had been addressed. For example, the manager had developed individual pain management plans for all the residents. Care Homes for Adults (18-65 years) Page 21 of 32 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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 who live at the home are enabled to voice their concerns and any complaints that are made will be dealt with thoroughly. Evidence: The home has a complaints procedure in place that gives people advice on how to make a complaint and what will happen if they do. The procedure is available in a number of formats including a pictorial and DVD guide, to ensure that the information is accessible. A record is kept within the home of any complaint made, action taken and subsequent outcome. Records viewed confirmed that the home had not received any complaints since their last inspection. The manager confirmed that all complaints received (if any) would be reviewed at the monthly managers meetings as part of the homes quality assurance processes. All homes are requires to have written procedures in place that should be followed in the event that it is suspected someone living in the home has been the victim of any kind of abuse - these are generally referred to as Safeguarding procedures. In discussion, the manager and staff spoke with demonstrated a good understanding of Safeguarding procedures and were confident that they would be supported in the event that they blew the whistle on poor practice. Care Homes for Adults (18-65 years) Page 22 of 32 Evidence: Care Homes for Adults (18-65 years) Page 23 of 32 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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 provided with comfortable, safe accommodation. Staff respect peoples surroundings. Evidence: Hollydale is a purpose built home with all facilities on the ground floor. All accommodation is offered on a single room basis and there are ample, accessible bathroom and toilet facilities. During our visit, we carried out a tour of the home and found all areas to be clean, warm and comfortable. We viewed a selection of residents bedrooms and noted that these were nicely personalised, decorated and furnished in line with peoples individual tastes and containing personal items such as pictures, ornaments and other treasured possessions. The manager and staff at the home treat residents space with respect and we observed staff knocking on peoples bedroom doors before entering. We were also advised that there is a policy in place that staff do not talk between themselves in the Care Homes for Adults (18-65 years) Page 24 of 32 Evidence: residents lounge areas (unless absolutely necessary) so as to remain respectful of their environment. The manager advised us that a number of environmental changes have taken place due to feedback received from the Service User Council. These include the replacing of some carpets and the provision of garden furniture. There is a policy and written procedures in place, in relation to the control of infection and all staff are made aware of these at the start of their employment. We were also able to confirm that staff are provided with training in infection control at the start of their employment. Care Homes for Adults (18-65 years) Page 25 of 32 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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 receive their care from carefully recruited well trained staff. Evidence: We viewed a selection of staff files that confirmed the home follow careful recruitment procedures. All prospective staff members are required to complete an application form which includes a full employment history. We saw evidence that any gaps in an applicants employment history are investigated and a record kept of reasons given. Formal interviews are carried out with all applicants and the manager also confirmed that residents wherever possible, are involved in the interviews and in the decision to offer an appointment. Prior to employment all staff members are required to provide two references, wherever possible from previous employers. On one file we viewed the staff member had only had one previous employer so she was asked to provide two character references in addition to her employer reference. We also saw evidence that staff must undergo a Criminal Records Bureau check prior to staring employment. In all the files we viewed we found that the checks had taken Care Homes for Adults (18-65 years) Page 26 of 32 Evidence: place before the staff member started work. There is a structured induction programme in place and records confirmed that new staff are provided with induction training at the start of their employment. More in depth induction which is in line with Skills for Care standards follows and new staff are expected to complete this within 8 weeks of their employment. Staff who responded to our written survey were very complimentary about the training provided. One staff member said I have never worked for a company where I get so much training, and other wrote The training is excellent and as a result staff are skilled and knowledgeable. In addition to the mandatory health and safety courses, staff are provided with training in a number of areas including sexuality, dealing with complaints, intensive interaction and communication skills. In addition staff are encouraged to gain their National Vocational Qualifications. At the time of our inspection 18 out of 20 staff members were qualified at level 2 or above. Additional duties associated with senior carer positions are recognised and training in areas such as appraisal is provided. In addition, all seniors are encouraged to obtain National Vocational Qualifications at level 3 and in some cases at level 4. We looked at staffing rotas and found that staffing levels were adequate to meet the needs of people living at the home. In discussion, one staff member said There is always enough of us on duty to spend time with residents doing activities. In addition, several staff members confirmed that the manager regularly arranges for extra staff to support residents on trips out for example. We revived a number of completed surveys from staff members and noted these to be very positive. Comments included The service looks after residents brilliant, they have caring staff, a great home and lovely management. Another staff member wrote The support network here is fantastic and there is always someone here to ask for advice. Care Homes for Adults (18-65 years) Page 27 of 32 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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 benefits from clear leadership and is managed in the best interests of people who live there. Evidence: The registered manager of the home has extensive experience and throughout the inspection demonstrated a good understanding of her role and that she was highly competent to manage the service. In addition, the manager communicates a genuine commitment to person centred thinking and was able to give a number of examples of how this had been put into practice. When responding to our written survey one staff member wrote The staff team are very motivated and caring and this is because of the manager. Prior to our visit the manager completed a comprehensive self assessment which explored all aspects of the service. The assessment was completed to a very good standard, gave details of a number of improvements that had been made since the last Care Homes for Adults (18-65 years) Page 28 of 32 Evidence: inspection and also demonstrated that the manager was able to identify areas for improvements and address them. There is a good approach to quality assurance and there are a number of ways in which residents are involved in this area. A Service User Council which is made up from people living in homes across the Dalesview Group meet on a regular basis to discuss the service. We saw a number of examples of changes that had been made as a result of requests or suggestions from the group. There is a health and safety policy in place which is supported by a number of individual procedures such as infection control and fire safety. Through discussion with staff we were able to confirm that the majority had received all their mandatory health and safety training. However there were a small number which we could not confirm. We advised the manager to create a training matrix which would be available in the home at all times that could show at a glance, all courses undertaken by staff and the dates they were completed. The registered provider of the home visits regularly and once each month carries out a thorough inspection during which she speaks with residents and staff. A report is then completed which is given to the manager and a copy is also provided to us. Staff members who responded to our written survey told us that the manager and the owners of the home were extremely supportive. One person wrote The managers door is always open and I know I could always go to her if I had any concerns whatsoever. Care Homes for Adults (18-65 years) Page 29 of 32 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 Adults (18-65 years) Page 30 of 32 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 34 A policy and procedures for the involvement of residents in staff recruitment should be developed so that they are always provided with opportunities to take part in a meaningful way. Dates of references and the receipt of CRBs should be recorded so that this information is easily accessible. Consideration should be given to enabling residents to have meaningful involvement in staff training programmes. A training matrix which includes all health and safety training should be maintained in the home so that the manager can ensure that all staff have received the necessary training and receive refresher training at the appropriate intervals. 2 3 4 34 35 42 Care Homes for Adults (18-65 years) Page 31 of 32 Helpline: 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 We want people to be able to access this information. 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