Care Home: Holmewood Manor Care Home

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What the care home does well Peoples needs, including for their health care needs, are mostly met in the way they expect and as agreed with them. People know who to speak with if unhappy and how to raise concerns or to complain. People are positive about their relationships with staff, telling us that they treat them with respect ensure their dignity and privacy. What the care home could do better: Provide a suitable replacement cupboard for the storage of creams and lotions that are kept on peoples behalf at the home. Maintain close monitoring of staffing levels during the late afternoon and evening to ensure they remain sufficient to meet peoples assessed needs. Ensure there is a registered manager for the service. Random inspection report Care homes for older people Name: Address: Holmewood Manor Care Home Barnfield Close Holmewood Chesterfield Derbyshire S42 5RH one star adequate 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: Susan Richards Date: 1 5 0 6 2 0 1 0 Information about the care home Name of care home: Address: Holmewood Manor Care Home Barnfield Close Holmewood Chesterfield Derbyshire S42 5RH 01246855678 01246852953 holmewood@hallmarkhealthcare.co.uk www.hallmarkhealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Hallmark Healthcare (Holmewood) Ltd Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 40 Number of places (if applicable): Under 65 Over 65 0 40 dementia old age, not falling within any other category Conditions of registration: 6 0 The maximum number of service users who can be accommodated is 40. The registered person may provide the following category of service only: Care Home with Nursing - Code N to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Old Age, not falling within any other category - Code OP, maximum number of places: 40, Dementia - Code DE, maximum number of places: 6 Date of last inspection Care Homes for Older People Page 2 of 10 Brief description of the care home Holmewood Manor is registered to provide accommodation,personal and nursing care for up to 40 older persons, including 6 people with dementia who require personal care. However, in accordance with its Statement of Purpose the home is not currently admitting people who require nursing care. The home is located off the main road in the village of Holmewood within walking distance of local shops and amenities with near access to the market town of Chesterfield and Junction 29 of the M1 motorway. The home comprises of 34 single bedrooms, 22 of which have an en suite facility and three double bedrooms, all having an en suite. Single bedrooms without en suites have wash hand basins fitted. There is a choice of lounge and dining rooms to each floor, accessible by both stairs and a shaft lift. There are also a number of environmental adaptations and equipment provided to assist people with physical disabilities. There is level access to pleasant gardens, with areas provided for relaxation and stimulation, including seating, garden tables and car parking spaces are provided. Activities are organised on a regular basis, and details of these can be found in the entrance hallway, along with key information about the home, including a copies of our last key inspection report. Twenty-four hour staffing is provided from a team of care support and hotel services staff led by a manager and with external management support contracted in from Hillcare Limited. Catering and laundry services are centralised. Information about fees charged by the home can be obtained directly from there. Fees are determined in accordance with individually agreed terms and conditions for those who may be eligible for assistance with funding from the local authority and, or primary health care trust. Or by way of individually agreed contracts for those who are privately funded. Care Homes for Older People Page 3 of 10 What we found: Holmewood Manor is assessed as a 1 star rated home. This means it provides adequate quality outcomes for people who use the service. This rating was given at our last key inspection of the home on 17 September 2009. Since our last key inspection, we have approved an application from the provider to vary their registration. This means that the home is now registered to provide personal and nursing care for up to 40 older people and also dementia care for up to 6 people. Although, as detailed in the homes Statement of Purpose, nursing care is not currently being provided. For the purposes of this visit we undertook an unannounced random inspection. This is a shorter targeted inspection, that focused on assessing how the home complies with specified Department of Health National Minimum Standards for Care Homes for Older People and associated Care Homes Regulations 2001. We also considered any information that we already hold about the service. This includes, Their annual quality assurance questionnaire (AQAA) that we ask the home to complete; any written notifications that we have received about events or incidents that have happened in the home; any complaints or safeguarding referrals made about the service; what other people have told us about the service and feedback from people who use the service. This included from 8 survey returns received. We have specified below the standards that we assessed at our visit in accordance with the relevant key outcome sections of the national minimum standards document referred to above. Our findings at this inspection were as follows, NMS OUTCOME SECTION TWO - HEALTHCARE. In their AQAA return, the home told us, they ensure people have comprehensive written care plans and that their personal and health care needs are suitably accounted for. They told us about some improvements they were making in approaches to peoples care. Including by way of introducing a revised, standardised needs assessment and care planning format and staff training. With the aim of promoting more person centred care and accurate monitoring of peoples health and wellbeing. At this inspection visit we spoke with the manager about some of the written notifications sent to us in the preceeding months in respect of falls and injuries to 2 service users and pressure ulcer incidence for one service user. We saw that their revised needs assessment and care planning format was recently introduced. Written care plans that we looked at for two of the people referred to above, were comprehensive and in accordance with their individually assessed needs. They were up to date, with regularly recorded reviews and recorded relevant inputs from outside Care Homes for Older People Page 4 of 10 health and social care professionals. People spoken with and surveyed told us that their needs are usually met, including their medical needs and that staff treat them with respect and promote their dignity and privacy. One person said, The staff are brilliant, nothing is too much trouble. We also saw that the requirement and recommendation we made at our last key inspection relating to practises and arrangements for peoples medicines were largely met. Although the newly purchased cupboard being used for storing peoples prescribed creams and lotions in the medicines room, was not of the correct type. NMS OUTCOME SECTION 4 - COMPLAINTS AND PROTECTION. In their AQAA return, the home told us they ensure that all complaints received are responded to and dealt with in a timely manner. They also gave us some statistical information that we asked for about any complaints received by them over the last 12 months. This tells us that there were five complaints made about the home. Three of these were subject to referral and investigation via local authority safeguarding adults procedures. Of the latter, 2 were substantiated and one partly. At our visit we looked at the homes complaints record. This provided details of the outcomes of investigations and any action taken as a result of their findings. Showing us that the provider has continued to meet the requirement we made at our last key inspection about complaints record keeping, in accordance with their action plan provided following that inspection. People spoken with and surveyed told us they knew who to speak with if unhappy and how to complain and we saw that a copy of the complaints procedure was openly displayed in the home. NMS OUTCOME SECTION 6 - STAFFING. At our last key inspection we raised serious concerns about inadequate staffing levels in the home and made a requirement about these. We also made a requirement that the staff training plan include for malnutrition care and assisting people with eating and drinking, falls and pressure ulcer prevention. At that time, the provider gave us satisfactory written information telling us about the action they were taking to ensure adequate staffing arrangements at the home and also for staff training. In their AQAA return, they told us that staffing numbers are maintained in accordance with peoples assessed needs. That the home is appropriately staffed and also that they provide suitable arrangements for staff to access the training they require. Care Homes for Older People Page 5 of 10 At our visit management told us that they use a basic formulary of one care staff to five residents during the day and one staff to ten residents at night and with additional staff, should peoples dependancy needs dictate this. For the 20 people accommodated, all in receipt of personal care only. We saw there to be 1 senior and 3 carers on duty together with the manager, an activities co ordinator and hotel services staff, including a full time administrator. Although we saw from looking at duty rotas that the number of care staff dropped to 1 senior and 2 care later in the day and at a time when there was no activities co ordinator present. Whilst we did not find any suggestion at our visit that peoples needs were not being met. We spoke with the manager about the need to ensure close monitoring of the evening staffing levels to ensure they remain sufficient to enable staff to meet peoples needs. People spoken with and surveyed told us that staff is usually available when they need them and that they listen and act on what they say. We saw that a revised training plan and staff training matrix was introduced. This included for nutrition and assistance with eating and drinking. The training plan indicated that all staff have now completed this although updated information was not transferred onto the staff training matrix. Falls prevention and management was still not included on the matrix or training plan. The manager said that this was due to be organised, but did not have any dates or supporting information for this. However, we saw via case tracking, and as referred to under the Healthcare section of this report. That a suitable approach to individual risk assessment and care planning was established in respect of falls management. We also found at our visit that out of sixteen care staff employed, ten have achieved an NVQ level 2 in care. With a further two people awaiting their completion certificates and with 4 staff registered to commence this. One carer has achieved NVQ level 3, with one awaiting their completion certificate for this. NMS OUTCOME SECTION 7 - MANAGEMENT. Since our last key inspection there has been a change of responsible individual acting on behalf of the provider. Their registration application was approved by the Commission on 30 November 2009. A separate company, Hillcare Limited, is also contracted in by the registered provider for the day to day mananagment and running of the home. There has been no registered manager for the home for a considerable time period, with a series of acting managers during this time period. At our last key inspection we made a requrement that the then manager submit her application for registration. However, this manager subsequently resigned. The current manager, who is a registered general nurse has been in post for some 4 months. She confirmed at our visit that she had not commenced the necessary process to submit her application for registration as manager of the home. We discussed with her that this must be commenced and with external management that there must be a registered manager for the home. Care Homes for Older People Page 6 of 10 What the care home does well: 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 2. Care Homes for Older People Page 7 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 31 9 A registered manager must be appointed for the home. Since we made this requirement the manager at that time has left her employment at the home. A new manager is recently recruited. As such we have agreed an extended timescale for her to commence this process and submit her application to the Commission by 31 July 2010 31/12/2009 To ensure that the person managing the home is of good character and fit to do so. Thereby promoting the best interests of service users who live there. Care Homes for Older People Page 8 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 9 13 Provide a suitable 31/07/2010 replacement cupboard from the current one in use for the storage of peoples creams and lotions. To ensure these are suitably stored in accordance with recognised guidance. 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 Staffing levels should be closely monitored during the late afternoon and evening to ensure they remain sufficient to meet peoples needs. There should be provision for staff to access training in falls prevention and management. 2 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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