Care Home: Holmes House Care Home

Similar services:

• Hillside
• Applegarth
• 122 Scorer Street
• Byars Care Home
• St Marys Nursing Home
• Jubilee Villa Care Home
• Bramble Lodge
• Parkmanor Residential Home

What the care home does well Meal times appear to be relaxed and enjoyable experiences with people being given time to make choices and eat their meals in a calm unhurried way. People spoke positively about the food saying it was good with one person commenting that it was, "good plain cooking which is what we like" The relationships between people who live in the home and staff were observed to be warm and friendly and people spoke positively about the staff describing them as "very good" and "lovely girls". Holmes House has recently been re-furbished and all communal areas and bedrooms have been redecorated. People said that they liked the way the home looked and had been involved in choosing colour schemes. Good arrangements are in place to make sure that people get the medication they need on time from well-trained staff. Good arrangements are also in place to make sure that people`s health care needs are met. Staff are available to accompany people to routine appointments if a member of their family is unable to do this. Care plans reflect people`s needs and how they should be met and good systems are in place to assess people`s needs before they move into the home. What has improved since the last inspection? No requirements for improvement were made at the previous inspection. CARE HOMES FOR OLDER PEOPLE Holmes House Care Home Kenilworth Road South Wigston Leicestershire LE18 4UF Lead Inspector Ruth Wood Unannounced Inspection 27th May 2008 09:20 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 Holmes House Care Home DS0000058967.V365213.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. Holmes House Care Home DS0000058967.V365213.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Holmes House Care Home Address Kenilworth Road South Wigston Leicestershire LE18 4UF 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) 0116 2782214 0116 2789379 holmeshousecares@aol.com Prime Life Ltd. Manager post vacant Care Home 48 Category(ies) of Dementia - over 65 years of age (25), Learning registration, with number disability (4), Mental disorder, excluding of places learning disability or dementia (6), Old age, not falling within any other category (48), Physical disability (10), Sensory impairment (4) Holmes House Care Home DS0000058967.V365213.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. No person falling within category DE(E) may be admitted to Holmes House when 25 persons who fall within category DE(E) are already accommodated within the home No person falling within category MD(E) may be admitted to Holmes House when 6 persons who fall within category MD(E) are already accommodated within the home. . No person falling within category LD(E) may be admitted Holmes House when 4 persons who fall within category LD(E) are already accommodated within the home. No person falling within category PD(E) may be admitted to Holmes House when 10 persons who fall within category PD(E) are already accommodated within the home. No person falling within category SI(E) may be admitted to Holmes House when 4 persons who fall within category SI(E) are already accommodated within the home. No person falling within category OP may be admitted to the home when 48 persons who fall within category OP are already accommodated within the home. To be able to admit the named person of category MD named in variation application number V34211 dated 14th August 2006 into Holmes House 8th November 2006 3. 4. 5. 6. 7. Date of last inspection Brief Description of the Service: Holmes House Care Home is a care home offering accommodation for up to forty eight older people (over 65 years of age). The additional needs of people choosing to move to the home may include physical disabilities, mental disorders, dementia, sensory impairment and learning disabilities. The home has been owned and managed by Prime Life Limited since June 2007. The home is located in South Wigston, approximately fifteen minutes by car from the Motorway (M1 and M69 junction). It is situated five minutes by car from the main high street in South Wigston, which has a range of local shops and facilities. The building is a modern purpose built property set in substantial grounds. The immediate area surrounding the home is a residential area. All areas of the home are accessible for people with limited mobility, and the home is equipped with a slow moving lift. There are attractive grounds, which residents can Holmes House Care Home DS0000058967.V365213.R01.S.doc Version 5.2 Page 5 access. Parking is available to the front of the property. The range of fees is currently £455 to £475. Additional charges are made for chiropody, hairdressing and newspapers. Information about the home is contained in the Statement of Purpose and Service User Guide. Holmes House Care Home DS0000058967.V365213.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This inspection took place on a weekday between 09:20am and 17:10pm. As well as this visit, information to inform this report was also drawn from the following sources: • Information from the Annual Quality Assurance Assessment (AQAA); The AQAA is a self-assessment, that focuses on how well outcomes are being met for people using the service. It also gives us some numerical information about the service. • Seven responses from people who live in the home to ten questionnaires sent out by the Commission for Social Care Inspection asking for their opinions about living at Holmes House. Because people with dementia are not always able to tell us about their experiences, a formal way to observe people was used to help understand this. Three people with dementia were observed to ascertain their general state of well-being, and how they interacted with staff members, other people who live in the home, and the environment. The observation took place in the main lounge between 11am and 12:15pm. We focused on how three people’s care needs were met. Care plans were looked at, discussion was held with one of the people and the interaction and care received by two others who have a diagnosis of dementia was directly observed as outline above. Discussion was also held with the acting manager and the key worker for two people about how they met these people’s needs. The lunchtime meal was observed including how staff assisted people who needed help with eating. Menu records were examined and people were asked for their opinions of the food served. Five other people were asked about their experiences of living in the home and the interaction between people and staff was observed. Three staff were interviewed about their experiences of training and supervision and their understanding of policies and procedures in place to protect the people who live in the home. Staff recruitment and training records were examined and arrangements in place for training and supervision were discussed with the acting manager. How medication is administered and managed was observed and discussed with the senior member of staff responsible for this on the day of the inspection. Holmes House Care Home DS0000058967.V365213.R01.S.doc Version 5.2 Page 7 All communal areas of the home were seen together with two people’s bedrooms. Fire maintenance and testing records were also looked at. What the service does well: What has improved since the last inspection? What they could do better: There have been some changes in the Regulations about how certain drugs (called controlled medication) should be stored in care homes. This means that the people who own Holmes House must make sure that these drugs are now stored in a special metal cabinet, fixed to a solid wall. The care plans of some people who had recently moved into the home did not contain a lot of information about their lives before moving into the home or their hobbies and social interests. Previously people had been asked about these as part of a ‘getting to know you’ exercise and it is recommended that this be reinstated as part of the assessment process. The observation of the people with dementia suggested that more structured activities should be developed for this group of people to increase the amount Holmes House Care Home DS0000058967.V365213.R01.S.doc Version 5.2 Page 8 of time that staff engaged with them. Care should also be taken that people are consistently addressed in an appropriate way and terms such as “good girl” are not used as these can demean the person being addressed. The acting manager and staff would benefit from an update in their knowledge of current multi-agency procedures in place, which safeguard and protect people and it is recommended that they access training in these areas available from the local authority. 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. Holmes House Care Home DS0000058967.V365213.R01.S.doc Version 5.2 Page 9 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 Holmes House Care Home DS0000058967.V365213.R01.S.doc Version 5.2 Page 10 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 – The home does not provide intermediate care therefore standard 6 is not applicable Quality in this outcome area is good People know their needs will be met because of good admissions procedures and the availability of relevant information about the home before they move in. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Statement of Purpose (a document that gives information about Holmes House) has been recently updated to reflect the current ownership and management of the home. A generic guide to all Prime Life Homes for Older People is also available and this is presented in an easy-read format with illustrations. Five of the seven people who responded to the Commission’s survey said that they had received sufficient information about the home before they moved in. One person who had recently moved to the home said that they and their relative had received information about the home before moving in and that their relative had visited to have a look around. The manager had also visited this person in hospital to assess their needs and had obtained a copy of the Holmes House Care Home DS0000058967.V365213.R01.S.doc Version 5.2 Page 11 comprehensive assessment completed by the placing social worker. This helped the manager to decide whether the home could meet this person’s needs. Holmes House Care Home DS0000058967.V365213.R01.S.doc Version 5.2 Page 12 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, 10 Quality in this outcome area is good Staff pay attention to people’s health, care and medication needs, which makes them feel looked after. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Five people who responded to the Commission’s survey said they always receive the care and support they need, two said that they usually did. We focused on how three people’s care needs are met. Their care plans contained information about how identified needs should be met and assessments about how to manage any specific risks such as those relating to mobility or social isolation. Observation of staff interaction with people indicated that the information within the care plan was being followed and the key worker demonstrated a good understanding of people’s needs. One person’s specific communication needs arising from their deafness were being met. Staff sat or stood where the person could see their lip pattern and used gesture and objects of reference appropriately. Staff also carried a note Holmes House Care Home DS0000058967.V365213.R01.S.doc Version 5.2 Page 13 pad and wrote down information for the person to read. This person said that they were satisfied with the care that they were receiving. Two people who were observed as part of the short observational study exhibited a positive mood when staff engaged with them, responding by smiling and touching. This would seem to indicate a good relationship between them and the staff team. The interaction between the people living at Holmes House and staff members was generally positive and most staff were observed to treat people with respect and address them in an appropriate manner although during the observation period one staff member did refer to one person as a “good girl” which given the person’s age was very patronising. This was fed back to the acting manager. A staff member was observed assisting one of the case tracked people to eat their lunch. The staff member maintained eye and physical contact with the person, encouraging them to eat in an appropriate way but allowing them to dictate the pace – never forcing them to eat. The person’s mood was positive throughout the period it was observed (20mins). In contrast another staff member assisting another person to eat spoke very little to that person – did not tell them what they were eating (the person was blind) or allow them to dictate the pace. The spoon was filled and put against the person’s lips and then put inside their mouth. This did not appear to be a happy or relaxed experience for the person. Both observations were fed back to the acting manager who agreed to act on this. Six people who responded to the Commission’s survey said that they always received the medical support they needed, one said that they usually did. Care plans and discussions with staff members showed evidence that people’s health needs were being appropriately addressed; records of GP and appointments with other medical practitioners such as opticians were logged. One staff member had accompanied someone to a hospital appointment on the morning of the inspection and the information from the appointment was fedback appropriately to the person’s relative, the manager and then recorded. One person was being looked after in bed because they had a sacral pressure sore. Staff entered their room to turn them every two hours and charts to record this were completed. This person was also using a ripple flow air mattress and District Nurses were actively involved in this person’s care. The administration of medication and a selection of Medication Administration Records were examined. Monitoring arrangements were in place for one person taking medication to control their thyroxin levels and these were detailed in the person’s care plan. The senior care worker administering medication had completed a 12-week course on its management and administration. They asked people if they wanted their ‘as required’ medication before administering it, checked the identity of the person and only signed the record after observing medication had been given. They also Holmes House Care Home DS0000058967.V365213.R01.S.doc Version 5.2 Page 14 displayed a good understanding of why the blood sugar levels of people with diabetes should be monitored and explained the arrangements in place in the home to do this. The storage for controlled medication appeared secure but does not conform to new requirements made by recent Amendments to Regulations relating to the Misuse of Drugs Act. Separate storage, which meets these requirements, must be obtained. Controlled drugs must be stored in a metal cupboard of a specified gauge with a specified double locking mechanism. The cupboard must be fixed to a solid wall or a wall that has a steel plate mounted behind it. The cupboard must be fixed with either Rawl or Rag bolts. The manager said that she would seek to obtain appropriate storage as soon as possible. Holmes House Care Home DS0000058967.V365213.R01.S.doc Version 5.2 Page 15 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, 15 Quality in this outcome area is good Most people are enabled to have a good lifestyle, although more structured activity may benefit some people with dementia. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Changes have recently been made to the way that food is served, with meals being served over longer periods to allow for a more flexible and relaxed approached. Cold puddings, biscuits, crisps and fresh fruit are always available. Meal times observed were relaxed and unhurried; people were offered a choice of main course and pudding and given the time to make a choice. Of the seven people who responded to the Commission’s survey two said that they always liked the meals – three said they usually did and two said they sometimes did. People spoken to at the inspection described the food as “all right” “excellent” “good”. One said, “ It is good plain cooking which is what we like”. Menu records suggest that the food served is ‘traditional English’ including roast meats, faggots, hot puddings and home made cakes. Fresh vegetables are served with the main meal. Other more ‘spicy’ options are available but these are not popular with most people living at the home. Suitable alternatives are available for people who have diabetes. Discussion with the people who live in the home and observation of their routines indicated that people could choose when they got up and when they Holmes House Care Home DS0000058967.V365213.R01.S.doc Version 5.2 Page 16 went to bed. One person said, “I stay up late - I usually don’t go to bed until about half past eleven.” All people currently living in the home are Christian and provision is made for those from the Catholic and Church of England communities to take part in services and receive communion. One woman explained how she received communion every week either from the priest or from “ a very nice woman”. This was clearly important to her. Church of England services are held and some local people visit the home to take part in these. Some care plans contained good information about people’s past lives, their hobbies, interests and the kinds of activities they liked to be involved in, including such detail as which newspaper they liked to read. This kind of information had not been recorded for those people most recently admitted. The observational study focussed on the interactions and state of wellbeing of three people with dementia. One person was asleep for the whole of the observational period until staff asked if they wished to go to lunch. One person had a positive state of wellbeing for 40 of the observation and a passive state of being for the remaining 60 . Staff interacted with them ten times during the observation, the majority of these being concerned with correcting their posture and ensuring that they had a drink. General findings from the observation are that more attention needs to be paid to ensuring that people with dementia have access to more sustained interaction with staff members and are enabled to participate in appropriate structured activities. The registered manager said that time was allowed for staff to interact with and arrange activities during the morning but there was no coordination of this process and staff seemed unsure as to how to use this time. Music was put on and two of the people observed as part of the study were giving percussion instruments and initially encouraged to shake these in time with the music. The interaction was very brief and staff quickly diverted their attention to more able people. The brief interaction however appeared to be very meaningful, particularly for one person who always responded to staff engagement with a smile. This positive response should be built on. Other people engaged actively with staff members singing and dancing and shaking percussion instruments. The manager had recently surveyed people in the home to ask for input on the kinds of activities or trips that they would like. Of the seven people who responded to the Commission’s survey one person said there were always activities arranged that they could take part in, two said there usually were and four said there sometimes were. As a result of this a trip to Twycross Zoo is being arranged. People spoken with later in the day said that sometimes there was bingo in the home. Throughout the day visitors were observed coming to the home, some to take people out, others to spend time with people in the home. Visitors are Holmes House Care Home DS0000058967.V365213.R01.S.doc Version 5.2 Page 17 welcomed to the home at any time and are encouraged to remain part of people’s lives. A separate lounge/dining area is available if people wish to entertain or have a meal with their visitors in private. Holmes House Care Home DS0000058967.V365213.R01.S.doc Version 5.2 Page 18 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, 18 Quality in this outcome area is good People are protected by staff awareness and procedures re complaints and safeguarding This judgement has been made using available evidence including a visit to this service. EVIDENCE: Copies of the complaints procedure are posted around the home and all seven people who responded to the Commission’s survey said that they knew how to make a complaint. All seven also said that staff listen and act on what they say. People spoken to on the day of the inspection said that they would tell a staff member if they weren’t happy. A record is kept of concerns and complaints received and the organisation responded appropriately and in a timely fashion to an anonymous complaint made to CSCI earlier in the year. Three staff were interviewed about their knowledge of safeguarding and abuse. All had received training in the Protection of Vulnerable Adults when the home was under the management of the previous owners and could explain examples of what would constitute abuse and were clear how to report any such incidents and to whom. They also understood who to take concerns to if they were not happy with the response from the organisation. The Registered Manager displayed an understanding of when and how to report safeguarding incidents but was a little unsure about new terminology (she said that she had not heard the term safeguarding) and the exact nature of the different agencies’ responsibilities. Three staff members’ recruitment records were examined; all contained a Criminal Records Bureau check made before they started work. Staff’s names Holmes House Care Home DS0000058967.V365213.R01.S.doc Version 5.2 Page 19 had also been checked against the vulnerable adults register. This together with obtaining writing references and identity checks helps to ensure that only suitable people work with the people living at Holmes House. Holmes House Care Home DS0000058967.V365213.R01.S.doc Version 5.2 Page 20 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, 26 Quality in this outcome area is good People benefit from living in a comfortable and clean environment This judgement has been made using available evidence including a visit to this service. EVIDENCE: All communal areas were seen, together with three people’s bedrooms. Holmes House has recently undergone a programme of refurbishment. New floor coverings have been fitted, all areas have been re-decorated and people have been able to choose the kind of floor and décor for their bedrooms. New furniture has been installed and a variety of paintings hung in the corridors. People who live in the home and the staff who work there both commented on the positive difference this had made. People’s bedrooms seen were light and well equipped, one person said, “I love my room”. There is a secure and accessible garden area equipped with comfortable furnishings. People said that they had enjoyed sitting in this area when the weather was good. The senior staff member ensures that windows and doors are secure before people retire to bed in the evening. Holmes House Care Home DS0000058967.V365213.R01.S.doc Version 5.2 Page 21 All areas of the home were fresh and clean and examination of staff records and discussion with staff confirmed that they had received training in infection control and they were able to discuss the measures taken to deal with any person living in the home who may be MRSA positive. All seven people who responded to the Commission’s survey said that the home was always fresh and clean. The design of the building means that some corridors do not benefit from natural light meaning that electric light must be switched on at all times. In one corridor some light bulbs were not working which made the corridor a little dark. Communal corridors should be regularly checked to ensure that all lights are working and bulbs replaced promptly so that the safety of people living and working in the home is not compromised. Holmes House Care Home DS0000058967.V365213.R01.S.doc Version 5.2 Page 22 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, 30 Quality in this outcome area is good People benefit from a well-trained staff team and positive recruitment processes This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff recruitment records showed that appropriate checks such as obtaining Criminal Records Bureau checks and checking people’s names against the vulnerable adults register had been made before staff started work. This, together with obtaining written references and identity checks, helps to ensure that only suitable people work at Holmes House. Staffing levels at the home appear to be sufficient to meet people’s needs. Of the seven people who responded to the Commission’s survey, three said that there are always staff available when needed and four said there usually were. All seven respondents felt that staff listen and act on what they say and many people gave positive comments about the staff team, “The girls are very good”, “They’re good to you here – can’t say otherwise” although one person said that “care has drifted a bit”. Five care staff plus a senior staff member are on duty for each shift during the day with three staff being on duty at night. In addition, catering, laundry and cleaning staff are employed. Although only one male staff member is employed this has enabled the request of one person for a male key worker to be satisfied. Over 50 of staff have achieved a National Vocational Qualification in Care at level 2 or above and some senior staff have achieved or are working towards Holmes House Care Home DS0000058967.V365213.R01.S.doc Version 5.2 Page 23 their level 3 qualification. All new staff have a formal induction; this was recorded on staff training files and supervision of new staff on induction was recorded on the staff rota. Staff have recently received an update in their moving and handling training and transfers observed indicated that they were competent in this area. Three staff spoke about the range of training they have received since working at Holmes House. This includes, dementia care, catheter and pressure area care and food hygiene and healthy eating. Holmes House Care Home DS0000058967.V365213.R01.S.doc Version 5.2 Page 24 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, 36, 38 Quality in this outcome area is good People benefit from living in a well-managed home This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since June 2007 Holmes House as been owned by Prime Life. The acting manager has been in post at the home since January 2008 and has completed her Registered Manager’s Award, a National Vocational Qualification in care at level 4 and has worked as a registered manager in a similar setting within the same company. She is currently reviewing staff training and supervision and all staff have recently undertaken an update in their moving and handling training. At the moment the acting manager is unable to access the CSCI professional guidance website and other professional websites as she does not have access to the Internet. This is limiting her ability to keep up-to-date with current Holmes House Care Home DS0000058967.V365213.R01.S.doc Version 5.2 Page 25 guidance and good practice and it is recommended that access be arranged as soon as possible. The parent company, Prime Life has a formal quality assurance system and the manager has recently surveyed the people who live in the home as to their views about activities and outings and some changes have been made in this area as a result of this consultation. A senior manager from Prime Life visits the home on a monthly visit to monitor the quality of care being provided and consult with the people who live and work in the home as to their views about this. Copies of their reports were seen to evidence this. Some people who live in the home receive support to manage small amounts of money. A clear log of all transactions is kept together with receipts. The system is audited by a representative from the company’s head office on a regular basis and appeared to be robust and help to protect people’s financial interests. Staff records and discussion with staff members indicated that staff receive regular, formal supervision from the manager which addresses their competence in various aspects of their role and looks at their learning and development needs. This should assist staff in meeting people’s needs. The AQAA, staff training records and discussion with staff indicated that staff have received training in food hygiene, fire safety, first aid and infection control. Fire systems and equipment are regularly tested and serviced and risk assessments are in place to deal with potential hazards such as tripping. Holmes House Care Home DS0000058967.V365213.R01.S.doc Version 5.2 Page 26 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 X X X 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 3 X 3 Holmes House Care Home DS0000058967.V365213.R01.S.doc Version 5.2 Page 27 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. 1 Standard OP9 Regulation 13(2) Requirement Secure storage must be put in place for controlled drugs to meet the requirements of the Misuse of Drugs and Misuse of Drugs (Safe Custody) (Amendment) Regulations 2007 Timescale for action 08/08/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7 Good Practice Recommendations It is recommended that the ‘Getting to Know You’ document be reinstated so that people’s interests and experiences can be incorporated into their care plans. Appropriate ways of addressing people who live in the home, which recognise and respect their status as adults, should be used consistently by all staff. More attention should be given to ensuring that people with dementia have access to more sustained interaction with staff members and are enabled to participate in appropriate structured activities. DS0000058967.V365213.R01.S.doc Version 5.2 Page 28 2. OP10 3. OP12 Holmes House Care Home 4. OP18 It is recommended that the acting manager and staff team access training in safeguarding vulnerable adults provided by the local authority to update their knowledge of terminology and procedures. Communal corridors should be regularly checked to ensure that all lights are working and bulbs replaced promptly so that the safety of people living and working in the home is not compromised. 5. OP19 Holmes House Care Home DS0000058967.V365213.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Holmes House Care Home DS0000058967.V365213.R01.S.doc Version 5.2 Page 30 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!