Care Home: Holmpark

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What the care home does well We spoke to three people who use the service at length in addition to general comments made by other people while being shown around the home. In general people are happy with the service provided, comments include: "As soon as I visited the home I knew this was the place for me, I had a comfortable feel about the home and I have been here for three years and I am very happy with the service, staff and the home in general``. "Staff are friendly I have my own flat with my own front door, I can join in activities or just sit in my flat and do things I enjoy, staff respect my wishes``. "There is an activity lady who asks what we want to do; we go on trips although there is no trips at the moment there will be in the summer. We have people come in to entertain us, we can join in if we want to``. "The food is very nice the staff come round each evening and ask us what we want the next day, the food is very nice``. "I have a lovely view of the garden and we now have a gardener so the garden is looking lovely``. "Staff are polite my relative is well looked after``. One relative said that the home keep them well informed about her relatives needs and progress, very good communication``. The home has made good progress in meeting requirements made at the last inspection in April 2007. Before people come to stay at the home the management team assess each individual to ensure they can meet people`s needs. This also gives the people the opportunity to visit the home and see for themselves what the home is like and meet the people who live there. People spoken to said when they first came they were made to feel very welcome and the home had a nice homely feel. Homlpark provides a clean and comfortable surrounding which people can live, their privacy is respected and people are encourage to personalise their flats and decorate according to their individual preferences and to reflect their age gender and culture so they feel comfortable in their surroundings. People are assessed for aids and adaptations so these can be provided to assist them in maintaining their independence. Regular checks are made with regards to the equipment people use to ensure safety. What has improved since the last inspection? We looked at the requirements made during the last inspection in April 2007; there has been steady progress in meeting these requirements. One person said that the home continues to seek their views about the home and how they would like to improve the service further. Training records showed that staff have the necessary skills and experience to ensure peoples needs can be met. The home has employed a gardener and people spoken to said the garden is looking lovely and are looking forward to sitting in the garden in the warmer weather. CARE HOMES FOR OLDER PEOPLE Holmpark 212 Hagley Road Edgbaston Birmingham West Midlands B16 9PH Lead Inspector Susan Scully Key Unannounced Inspection 29th April 2008 09:30 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 Holmpark DS0000016908.V363228.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. Holmpark DS0000016908.V363228.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Holmpark Address 212 Hagley Road Edgbaston Birmingham West Midlands B16 9PH 0121 456 3738 0121 454 4495 pearl.moore@anchor.org.uk keri.sherwood@anchor.org.uk Anchor Trust 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) Mrs Pearl Moore Care Home 39 Category(ies) of Dementia - over 65 years of age (39), Old age, registration, with number not falling within any other category (39), of places Physical disability over 65 years of age (39) Holmpark DS0000016908.V363228.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to accommodate 39 adults over the age of 65 who are in need of care for reasons of old age, not falling within any other category (39), Physical Disability over 65 years of age (39), Dementia (39). Flat 39 is to be used only for the purpose of respite care. Minimum staffing levels must be maintained to at least 4 care staff at all times during the waking day. This must be increased at peak times to meet The needs of the service users. Care manager hours, ancillary staff and activities co-ordinator should be provided in addition to care staff. 26th April 2007 2. 3. 4. Date of last inspection Brief Description of the Service: Holmpark is registered to provide residential care for up to 39 older people for reasons of old age, dementia or physical disability. It is situated on a main road close to Birmingham City Centre and is within easy reach of public transport facilities and other amenities. The Home is a listed building, which had an extension built in 1988 and is run as one unit. It is well maintained both internally and externally and has adequate off road parking to the front of the Home. There is a spacious secure garden however at the current time people using the service have to negotiate steps to access the lawned area of this. Accommodation is provided over three floors, which are accessible via two passenger lifts, in 37 single flats and 1 double flat. Each flat has a small kitchen area, equipped with a small fridge, telephone, television points and ensuite facilities that consist of a toilet and hand washbasin. There is an en-suite shower in the two ground floor flats, one of which is designated for respite care. There is a range of assisted bathing facilities throughout the Home and staff are available to provide assistance in these areas. Aids and adaptations are available in order to enhance the quality of the lives of people using the service that have physical disabilities. There is a laundry service and the flats are cleaned weekly. Smoking is permitted in individual flats following a risk assessment so that people using the service are safeguarded. There are large notice boards in the reception area of the Home displaying any forthcoming events and other information of interest to people using the service. There are a variety of activities for people to participate in should they choose. Holmpark DS0000016908.V363228.R01.S.doc Version 5.2 Page 5 Copies of the most recent CSCI inspection report and newsletters were available on display at the Home for anyone interested to refer to. The weekly fee to live at the Home is between £374.50 and £441. Items not covered by the weekly fee include hairdressing and private chiropody, dental and optical care. Holmpark DS0000016908.V363228.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. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for the people who use the service and their views of the service provided, meaning they tell us if the home is meeting their needs, if the home is flexible and suits their life style, and if the home enables them to maintain their independence, preferences and choice of how they want to be supported and the homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provisions that need further development The inspection was completed over one day by one inspector. The home did not know that an inspection of the service was taking place. As part of the inspection process three people were case tracked this involves establishing individuals experiences of the service provided or observing practises of individual staff and how they have been trained to deliver a service that promotes the persons well being and choices. We also discuss people’s care and look at care files focusing on outcomes for people. Case tracking can help us understand the experiences of people who use the service. In addition to this, information is looked at during the inspection such as polices and procedures, and the general operation of the home in relation to meeting peoples needs. We also contact other professionals involved with the home such as contract monitoring officers for their views of the service provided. The home is also required to complete an annual quality assurance assessment (AQAA). The Commission sends this document to the provider before the inspection. The AQAA shows what the home is doing well and if and what the home could do better. The completion of the AQAA is a legal requirement that the provider must complete as part of the inspection process. A safeguarding referrals been made and is currently under investigation. This will not be referred to in this report. The outcome will be referred to in the next key inspection report once the investigation has been completed. Holmpark DS0000016908.V363228.R01.S.doc Version 5.2 Page 7 What the service does well: What has improved since the last inspection? Holmpark DS0000016908.V363228.R01.S.doc Version 5.2 Page 8 We looked at the requirements made during the last inspection in April 2007; there has been steady progress in meeting these requirements. One person said that the home continues to seek their views about the home and how they would like to improve the service further. Training records showed that staff have the necessary skills and experience to ensure peoples needs can be met. The home has employed a gardener and people spoken to said the garden is looking lovely and are looking forward to sitting in the garden in the warmer weather. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Holmpark DS0000016908.V363228.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 Holmpark DS0000016908.V363228.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): 3, 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s needs are assessed before they move into the home; this means that both the home and the individual can be confident the service has the necessary skills of staff and provision to meet the people’s needs. EVIDENCE: When a referral is made by the placing authorities the home complete a full needs assessment. We looked at the pre assessment of three people. The documentation available showed us that their in consultation with the person moving into the home, relatives and social workers to ensure the service provided can meet the individual needs. When speaking with people using the service one person said, “I knew when I visited this was the place for me, it felt comfortable and homely’’. The information provided to assist the person making the decision to move into the home is in the form of a service user guide and statement of purpose. These documents tell people about the service provided, the history of the Holmpark DS0000016908.V363228.R01.S.doc Version 5.2 Page 11 organisation, staff experience and skills, how they can be expected to be cared for, and the terms and conditions of the service provided. If a person is unable to visit the home a representative from the organisation will visit the people in their own environment to complete an assessment. This means that people have the opportunity to ask questions, and meet the staff. This will ensure the person’s needs are known and can be met before moving in to the home. It is recommended as part of the assessment process the person wishing to move into the home is provided with a copy of the last inspection report as part of the information given to people. In addition to this information it is recommended that the prospective residents has information such as what other people have said who live in the home, to include any negative response. This will show the home is open to the views of people and taken action to put things right when they go wrong. People come to stay at Holmpark on a four-week trial period so that they have the opportunity to settle in to life at the Home. A six month and annual care review is undertaken so that people have the opportunity to put forward their views about the care and support provided to them whilst living at the Home. Pre review questionnaires are distributed to people using the service so that their views could be used in the planning of the review. The care needs of existing people using the service are reassessed prior to return to the Home following hospital admissions in order to ensure that their care needs could still be met at Holmpark. Holmpark DS0000016908.V363228.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. This judgement has been made using available evidence including a visit to this service. The care needs of people living in the home are met in a way the person choose encouraging independence dignity and choice. Medication records and administration are carried appropriately to ensure people living in the home receive their medication safely. EVIDENCE: We looked at the information provided in three care plans they showed us that staff have guidance of how the person needs would be met on a daily bases. They were detailed to ensure people were cared for safely. Information contained in care plans identified, medical conditions, the person’s history, what aids and adaptations people need, they include details of the involvement of other health care professionals such as doctors, dentists, chiropodist, consultants, and they identify how the support should be provided to meet people’s needs. Holmpark DS0000016908.V363228.R01.S.doc Version 5.2 Page 13 The care plans contained information about nutritional screening to ensure people’s dietary needs were met and those at risk; a risk assessment had been completed. Pressure relieving equipment is used where the person has been assessed; this is to prevent pressure sores. There are details of the treatment and the type of equipment being used. They also provide details about medication and social care needs. In addition to the care plans there is a daily record of how the care is provided each day. The daily records need further improvement, as those seen gave repetitive information. For example one care plan said the person would refuse assistance with personal hygiene and this should be reported. The daily records showed over a period of nine days the person had either refused assistance with washing or was already dressed when staff attended. The daily records said over this period “refused assistance with personal hygiene’’. When the care needs of this person had been reviewed on two occasions over this period this information was not acted upon as the review said “Care plan no changed working well The information provided in daily records clearly showed the care plan for this person where this need had been identified was not working. There was no further information to say that this had been reported to the management team and action had been taken to readdress this need. In one daily record there was information about when the doctor had visited this person and the entry said “the doctor came today and prescribed some more’’. It could not be determined what this meant and the inspector asked the team leader. The team leader informed the inspection this meant more medication. One care plan said the person was at risk of falling out of bed the person had attended the falls clinic and they had informed the home that there was nothing else they could do. The person had fallen out of bed on two occasions and sustained injuries. The inspector requested that the home seek further advice about aids and adaptation that will assist in the prevention of this person falling out of bed and consult the doctor again. At the time of writing the report the home had taken action and a risk assessment was forwarded to the commission giving details of the provisions in place to minimise further injuries. Where risk assessments had been completed the information was not always clear. For example one risk assessment said the person would refuse assistance with personal hygiene, the information did not inform the reader what risks where associated with this. Holmpark DS0000016908.V363228.R01.S.doc Version 5.2 Page 14 People using the service had access to a range of Health and Social Care Professionals including district nurses, psychiatrists, dieticians and community psychiatric nurses. People have the option of retaining their own General Practitioner on admission to the Home (If the GP is in agreement) We looked at the medication administration records for the three people as part of the case tracking. When staff administer medication the medication administration records is signed. Staff who administer medication have received appropriate training in the safe handling of medication to ensure people receive their medication safely. Records showed us that when medication is brought in to the home this is checked against prescription that have been prescribe by the person’s general practitioner. The home has a controlled drugs register that is signed and checked each time the medication is given. The medication is stored appropriately and where needed there is a fridge to store medication at the correct temperature. When we spoke to people we asked where they felt the home could improve. One relative said the home could improve further in looking after people’s personal belonging such as hearing aids, glasses, and ensure peoples clothes were fully ironed before they are put away. One relative has had to purchase three hearing aids; these have been covered by insurance there is still the inconvenience of her relative being without an hearing aids for a period of time. People spoken to throughout the day said staff treat them with respect and ensure they are looked after. Observation showed us that staff were respectful when speaking with people and gave support when needed. It was also observed that staff were discreet when assisting with personal care needs. Holmpark DS0000016908.V363228.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. This judgement has been made using available evidence including a visit to this service. The home provides varied social activities and outings that meet the expectations of people living at the home providing them with interest and pleasure to enhance the quality of their lives. People who live at the home are able to exercise choices over their daily routines to promote individuality and independence. A wholesome and varied diet is offered and specialist needs are catered for. EVIDENCE: People spoken to during the visit expressed their contentment of the activities provided by the home. There is a wide Varity of activities available that include quiz nights, arts and crafts, music and movements, sing a long, cream teas. This information is displayed on the notice bored. There is an activity person who at present is discussing with people their interests to see what type of activities people would like to do. This will enable her to form a planned programme of activities for the remainder of the year. Holmpark DS0000016908.V363228.R01.S.doc Version 5.2 Page 16 People living in the home are encouraged to participate in activities of their choice outside the home in the local community. Relatives spoken to during the visit said they are always made to feel welcome at any time. One relative said the home invites us to social activities and we can visit at any time. One person who said they have lived at the home for three years it not like a home its like and hotel where you can come and go as you please. Staff are very kind and make sure I am all right. The library that is in the home has many books in different formats, such as large print, audio books and Braille. The home has an open visiting policy and visitors are welcome at any time. There are no fixed rules at the home people go to their flats when they want to, get up when they want to, and go to bed when they want to. One person said “ Its very relaxed its not like you are in a home you still have your independence but have help when you need it’’. We looked at the meals during the lunch time period the tables are set to a good standard making the dining areas very welcoming. Staff were seen to assist people with their meals discreetly while having conversation with other people sitting on the table. This meant it was not so invasive to other diner and the person needing the help was not excluded from the conversations. Meals were of a good quality. People said the meals are always well presented and hot. One person said we are waited on as if we are in a restaurant. The menus were seen, these showed us that there is a wide choice of food available to include people different tastes such as traditional English meals and different dishes so all culture can be catered for. There was ample food available for people to have snacks, or different meals to the menu if they did not like what was offered. In the kitchen areas there is information available for people with special diets such as people with diabetes. When speaking with the chef she informed us that special religious diets and beliefs can be catered for when required. The menu is discussed with the people living in the home regularly to ensure people are happy. The chef also showed us a book that contained complements, complaints or concerns about the meals and what action has been taken. In addition to this the person who had voiced the concern the chef ensured they were consulted about the outcome, and this information was recorded. Holmpark DS0000016908.V363228.R01.S.doc Version 5.2 Page 17 Cooked breakfasts are available twice a week for those who wish to have them. Snacks are also available if a person wanted food during the night. In the dining area there were aids and adaptation available for people who needed them such as raised chairs, cutlery and plate guards to promote the dignity of the people requiring assistance. In general people living in the home said the food was good. Holmpark DS0000016908.V363228.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. This judgement has been made using available evidence including a visit to this service. Peoples’ opinions are listened to and they are encouraged to raise concerns, which would be dealt with effectively. The procedures and staff practices suggest that people living in the home are protected from risks of abuse. EVIDENCE: The home has a complaints procedure that is displayed in the front entrance to the building. Since the last inspection there were five complaints recorded in the complaints log. The manager had addressed each complaint satisfactorily. Letters to the complainants were contained in the complaints folder. It is recommended when sending letters of the outcome of the complaints investigation, a questionnaire is also sent to the complainants. This will give the person the opportunity to respond to say if they are satisfied with the outcome and the way the complaint was investigated. This information can then be used as part of the homes quality assurance. One person spoken to during the visit said “I have made a complaint and was very pleased with the way it was dealt with’’. Another person said “if you tell some one, such as staff or the management about concerns they deal with the concerns right away’’. Holmpark DS0000016908.V363228.R01.S.doc Version 5.2 Page 19 An allegation had recently being made; this has been referred to the social worker and police who are completing an investigation. The outcome has not yet been concluded. The home has an adult protection procedure that is in line with the Birmingham multi agency guidelines. Staff have received training in the safe guarding of people. The manager and her team know who they have to report to in the case of an allegation being made and put measures in place to safe guard people while under investigation. Holmpark DS0000016908.V363228.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, 24, 25, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a warm comfortable environment that meets their needs and preferences. EVIDENCE: We looked around the home and visited people in their own flats. The flats we saw were very personal to the individual. In one flat the people had brought their own furniture instead of the furniture used by the home. The person said it was their choice. People are encouraged to bring personal possessions from home and decorate to their choice and preferences. The communal areas were clean and there were no offensive odour throughout the home. Holmpark DS0000016908.V363228.R01.S.doc Version 5.2 Page 21 The dining area was well presented with tables laid accordingly for the lunchtime meals. The kitchen area was very clean and equipment used stored appropriately. During the last inspection there were concerns raised about the lounge area not being staffed and felt that this could lead to people falling and going unnoticed for a period of time. The manager said the lounge areas are always staff to ensure people safety. When we walked around the home it was noted that staff were in the lounge areas so people were safe. It is recommended that the rota sets out who on each shift is required to monitor the lounges to ensure people safety. There is a call bell facility in each flat so people can summons assistant if required. One person living in the home had a pendent to summon help if needed as she sometimes had falls. The home has a loop system around the home for people who are hard of hearing; this enables them to switch to the frequency of the loop system so they can hear well in different areas of the home. There is a safe facility in each flat where people who are able to look after their own valuables can place them to keep them safe. People spoken to said the home is clean and comfortable and they feel safe. A gardener has been employed to ensure that residents are able to sit in the garden during the warmer weather. There were grab rails around the home to support people. Chairs are placed around the home so people can sit down if they wish. Holmpark DS0000016908.V363228.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. This judgement has been made using available evidence including a visit to this service. Staffing levels are maintained in sufficient numbers to ensure that peoples needs can be met. Recruitment practices are good and this protects people living at the home from the risk of harm. EVIDENCE: We looked at the staffing levels in the home to ensure that there were adequate numbers of staff on duty to meet peoples changing needs. On the day of the visit the staff levels consisted of the manager, deputy manager, team leader, four care staff, one kitchen manager one chef, and one domestic. The people living in the home have varying needs. The staffing levels were discussed with the manager and it is recommended that she complete a dependence assessment to ensure the numbers of staff are equivalent to the needs of the people living in the home. At the time of the inspection staffing levels met people’s needs. All staff completes a comprehensive induction when they commence employment, including training in health and safety, food hygiene, manual handling, infection control, catheter care, protection of vulnerable adult, dementia, fire, back care, and first aid this enables staff to have the knowledge and training to meet peoples needs. Over half of the staff team have completed NVQ level 2 or above in care. Holmpark DS0000016908.V363228.R01.S.doc Version 5.2 Page 23 This means the people living in the home can be confident that the skills of the staff team will enable them to be cared for safely. The most recently recruited members of staff files were sampled this consisted of three staff. We looked at the measures the home had taken to ensure the staff appointed were suitable to work with vulnerable people. The files sampled included application form, interview notes, medical clearance, job description, references, employment history and protection of vulnerable adult checks including enhanced criminal record checks. Supervision records and a full comprehensive induction had taken place. People living in the home can be confident that the home makes all the necessary checks before they employ people to ensure people are safeguard. Holmpark DS0000016908.V363228.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, 34, 35, 36, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is experienced and is constantly striving to make ongoing improvements for the benefit of those people who live in the home. Arrangements in respect of health and safety are robust and serve to protect people from risks of injuries. EVIDENCE: The manager has the necessary skills and experience to manage the home in a way that ensures people are protected from harm. There are clear lines of accountability and the ethos in the home is good. People spoken to during the visit included residents, staff and relatives who said the management team were approachable and they had confident any concerns raised would be dealt with. Holmpark DS0000016908.V363228.R01.S.doc Version 5.2 Page 25 The management assist people with the safe keeping of valuables if they are unable to do this for themselves. The home keeps a small amount of money that relatives give them for such things as hairdressers, chiropodist and toiletries. We looked at the records that the home keep in respect of any money held on behalf of individuals. The records showed us that the accurate record when any money is spent and receipts are obtained. The home have sheets were they record this information and those sampled had accurate balances. The home holds regular meetings with residents, relatives, and staff to ensure continuity of care. Supervision topics include residents’ issues, proposed activities, training and development, concerns/achievements, communication, this ensures that staff always knows how to support the people living in the home. This assures people living at the home that they will always receive care and support from supervised staff. Health and safety checks are completed to ensure safe working practise such as fire drills, fire training, electrical equipment, manual handing equipment and routine maintenance. Holmpark DS0000016908.V363228.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 X X 3 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 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 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 3 3 3 X 3 Holmpark DS0000016908.V363228.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 OP7 Regulation 14(2)(a) (b) Timescale for action Daily records must show how the 01/07/08 care plan influences the day-today care of people living in the home. When the care need identified is not being met alternative action must be taken to re address the need. This will ensure people’s needs are monitored. All risks assessments must give 01/07/08 specific guidance to staff to minimise the risks. This will ensure peoples needs can be met without undue risk to their welfare. Requirement 2 OP7 13(4)(b) 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 OP27 Good Practice Recommendations It is recommended that she complete a dependence assessment to ensure the numbers of staff are equivalent to the needs of the people living in the home. At the time DS0000016908.V363228.R01.S.doc Version 5.2 Page 28 Holmpark 2. OP16 3 OP1 of the inspection staffing levels met people’s needs. It is recommended when sending letters of the outcome of the complaints investigation, a questionnaire is also sent to the complainants. This will give the person the opportunity to respond to say if they are satisfied with the outcome and the way the complaint was investigated. It is recommended as part of the assessment process the person wishing to move into the home is provided with a copy of the last inspection report as part of the information given to people. In addition to this information it is recommended that the prospective residents has information such as what other people have said who live in the home, to include any negative response. This will show the home is open to the views of people and taken action to put things right when they go wrong. Holmpark DS0000016908.V363228.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection West Midlands Office West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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. 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