Care Home: Hollydene EMI Rest Home

What the care home does well This section was not assessed on this occasion What the care home could do better: A care plan must be developed for each service user that describes in detail how the assessed needs of the people using the service are to be met. This will help staff to understand how to deliver person centred care in response to assessed needs. An up-to-date record of all training completed, including induction training must be maintained for each member of staff. This will help to provide evidence that staff have completed all the necessary training for their roles and responsibilities. Risk assessments and management plans for moving and handling and the use of aids must be kept under regular review and clearly outline handling instructions and equipment to be used. This will help to ensure that unnecessary risks to the health and safery of residents are identified and as far as possible eliminated. A system should be established to verify that the dependency needs of the people using the service and the resultant staffing levels in the home are appropriate. This will help in workforce planning and ensure the needs of the people using the service are met. A minimum staffing ratio of one staff to seven residents should be maintained to ensurethe health, safety and wellbeing of residents is safeguarded. All outstanding staff should complete training in dementia awareness and mandatory subjects, to ensure best practice. Training records should clearly detail which staff have completed training in the use of the hoist and other aids / adaptations and all outstanding staff should complete this training as a matter of priority. Random inspection report Care homes for older people Name: Address: Hollydene EMI Rest Home 46 York Road Southport Merseyside PR8 2AY two star good service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Daniel Hamilton Date: 2 1 1 0 2 0 0 9 Information about the care home Name of care home: Address: Hollydene EMI Rest Home 46 York Road Southport Merseyside PR8 2AY 01704566846 Telephone number: Fax number: Email address: Provider web address: maxine.nichol@cedarscaregroup.co.uk Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Hollydene Care Ltd care home 25 Number of places (if applicable): Under 65 Over 65 25 dementia Conditions of registration: 0 The registered person must at all times appoint a suitably qualified manager that is registered with the CSCI Date of last inspection Brief description of the care home Hollydene is a residential care home that specialises in the care of older people with dementia. The home is registered to care for up to 25 residents. The home is a large old detached house to which more modern extensions have been added to the side and at the back. There is a large enclosed garden at the rear of the home; the garden to the front has been given over to off road parking. Hollydene provides permanent residential care for its residents. It does not provide nursing care. Hollydene is established in a residential area very close to Birkdale village and railway station. Southport town centre is about 1 mile. The service is managed by Maxine Nichol and the Registered Provider is Hollydene Care Ltd. Fees at the time of the last inspection ranged from £418.70 to £435.00 per week. Care Homes for Older People Page 2 of 10 Brief description of the care home Care Homes for Older People Page 3 of 10 What we found: This random inspection was undertaken on 21st October 2009 and lasted approximately 4 hours. The purpose of the inspection was to investigate an anonymous complaint which was received by the Care Quality Commission during October 2009. The complaint concerned a number of issues including: staffing levels; training in moving and handling and the use of hoists; the general care of two residents with limited mobility and an individual who had a history of challenging behaviour. Outcome Area - Health and Personal Care. The files of three residents who were named in the complaint were selected to view during the visit. Each file was found to contain a pre-admission assessment of need however only two of the files seen contained a care plan. The registered manager was unable to locate the missing care plan during the visit. The two care plans viewed were completed to a very basic standard, did not describe in detail how the needs of residents were to be met in relation to mobility, mental health and other significant areas of need and had not been kept under regular review. Furthermore, risk assessments viewed for moving and handling did not provide clear instructions for staff on how the mobility needs of residents were to be managed. Outcome Area - Staffing. The staffing rota was viewed during the inspection. It was noted that two staff were on duty during the day of the visit to support 20 residents. The registered manager reported that she was also available to assist with personal care however this was not clearly recorded on the rota. The rota detailed that two staff were also on duty in the afternoon. The registered manager reported that she would remain on duty until approximately 4.00pm and return at 4.30pm to work until 8.00pm. Again, this was not clearly reflected on the rota. Rotas examined highlighted that during the night shift staffing levels occasionally varied from three to two. The registered manager and a director of the company reported that staffing levels had occasionally been reduced to two at night given the lower occupancy levels and arrangements had been made for another staff member to be on-call when such changes were made. At the time of the visit the registered manager did not have a system in place to monitor the dependency needs of residents and the resultant staffing levels in the home. The registered manager was recommended to utilise a tool developed by the residential forum on behalf of the department of health. The two staff on duty were spoken with during the visit. Staff reported that the staffing levels were generally adequate to meet the needs of the people they cared for, except when the staffing levels occasionally reduced to two. Care Homes for Older People Page 4 of 10 Staff also reported that the issues relating to the behaviour of a resident had been resolved following a review of the service users medication and this was confirmed in discussion with the registered manager. The service user was spoken with during the visit and appeared calm and content. The care plan relating to individual and the management of any past inappropriate behaviour could not be located during the visit. Staff spoken with reported that they had both completed moving and handling and use of the hoist training. At the time of the visit the training matrix was not up-to-date and did not clearly identify which staff had completed training in the use of the hoist or whether this subject was covered as part of the moving and handling training. The matrix also detailed that only two staff had completed training in dementia awareness. The registered manager reported that staff had recently completed distance learning dementia training and that she had removed individual records of staff training from personnel files as recommended by an external consultant. Staff interviewed confirmed that two residents named in the complaint required support to mobilise using a hoist and to transfer from a bed to a wheelchair. Conversely, the registered manager reported that the two residents did not require the use of a hoist to transfer and that staff used standing belts for transfers. On the day of the visit the two residents concerned were observed to be resting in bed at approximately 1.30pm and a hoist was noted to be stored in the shared bedroom. Care plans did not did not describe in detail how the needs of residents were to be met in relation to mobility, mental health and other significant areas of need as previously mentioned. What the care home does well: What they could do better: A care plan must be developed for each service user that describes in detail how the assessed needs of the people using the service are to be met. This will help staff to understand how to deliver person centred care in response to assessed needs. An up-to-date record of all training completed, including induction training must be maintained for each member of staff. This will help to provide evidence that staff have completed all the necessary training for their roles and responsibilities. Risk assessments and management plans for moving and handling and the use of aids must be kept under regular review and clearly outline handling instructions and equipment to be used. This will help to ensure that unnecessary risks to the health and safery of residents are identified and as far as possible eliminated. A system should be established to verify that the dependency needs of the people using the service and the resultant staffing levels in the home are appropriate. This will help in workforce planning and ensure the needs of the people using the service are met. A minimum staffing ratio of one staff to seven residents should be maintained to ensure Care Homes for Older People Page 5 of 10 the health, safety and wellbeing of residents is safeguarded. All outstanding staff should complete training in dementia awareness and mandatory subjects, to ensure best practice. Training records should clearly detail which staff have completed training in the use of the hoist and other aids / adaptations and all outstanding staff should complete this training as a matter of priority. 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 2. Care Homes for Older People Page 6 of 10 Are there any outstanding requirements from the last inspection? Yes R No £ 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 7 15 Evidence must be provided 31/07/2008 that relatives have confirmed the contents of care plans Screening must be provided 31/05/2008 to ensure that those who use shared rooms have their privacy upheld Reports relating to monthly visits conducted by a representative of the organisation must be consistently provided to the Acting Manager. PREVIOUS REQUIREMENT AT LAST KEY INSPECTION NOT MET 31/07/2008 2 10 12 3 33 26 Care Homes for Older People Page 7 of 10 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, 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 1 7 13 Risk assessments and 23/11/2009 management plans for moving and handling and the use of aids must be kept under regular review and clearly outline handling instructions and equipment to be used. This will help to ensure that unnecessary risks to the health and safety of residents are identified and so far as possible eliminated. 2 7 15 A care plan must be developed for each service user that describes in detail how the assessed needs of the people using the service are to be met. This will help staff to understand how to deliver person centred care in response to assessed needs. 23/11/2009 3 30 19 An up-to-date record of all 23/11/2009 training completed, including induction training must be maintained for each member Page 8 of 10 Care Homes for Older People Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 of staff. This will help to provide evidence that staff have completed all the necessary training for their roles and responsibilities. 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 27 A system should be established to verify that the dependency needs of the people using the service and the resultant staffing levels in the home are appropriate. This will help in workforce planning and ensure the needs of the people using the service are met. A minimum staffing ratio of one staff to seven residents should be maintained at all times to ensure the health, safety and wellbeing of residents is safeguarded. All outstanding staff should complete training in dementia awareness and mandatory subjects, to ensure best practice. Training records should clearly detail which staff have completed training in the use of the hoist and other aids / adaptations and all outstanding staff should complete this training as a matter of priority. 2 27 3 30 4 30 Care Homes for Older People Page 9 of 10 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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