Care Home: Holywell Park Residential Home

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What the care home does well The home continues to be welcoming to new residents and their relatives, and residents felt efforts had been made by the staff to help them make the transition to living in a home. Residents are assured the home can meet their needs. The health care needs of residents are well managed and the home works closely with the district nurses and local GP. The activities at the home are varied and frequent and trips out fortnightly are enjoyed by many of the residents. Residents feel valued, listened to, and a part of the home, one resident said "this is my home now, and I make my decisions just as I did before". Residents said " the food is lovely", and "plenty of choice". There is a continual programme for refurbishment and decorating which keeps the home in good order. The home has a stable staff group who are well trained and continue to enjoy working at the home. The manager ensures the approach of the home is open, positive and inclusive and residents, relatives and staff feel they are a central part of the home. What has improved since the last inspection? Care plans are now reviewed monthly. There are new menu and activity boards with clear, bold information for residents to read and where they can add their own comments. The home has obtained a 4 star rating from the Environmental Health department. The cook visits residents daily regarding their choice of menu for the day. The home has just employed a deputy manager who will share some of the managerial tasks with the manager. What the care home could do better: The quality of the daily record could be improved to better reflect how residents spent their day. All residents should have a risk assessment for falls. The use of a professionally recognised tool for nutritional screening for all residents will help to identify any resident at risk of becoming malnourished. Key inspection report Care homes for older people Name: Address: Holywell Park Residential Home Hodsoll Street Ash-cum-Ridley Wrotham Kent TN15 7LE     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Justine Williams     Date: 0 6 0 7 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 24 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Holywell Park Residential Home Hodsoll Street Ash-cum-Ridley Wrotham Kent TN15 7LE 01732822215 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: holywellpark@aol.com Holywell Park Ltd care home 58 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 58. The registered person may provide the following category/ies of service only: Care home only - (PC) 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 (OP). Date of last inspection Brief description of the care home Holywell Park is a family owned and run residential care home that accommodates up to fifty-eight older people. It has forty-eight bedrooms and two apartments. Three shaft lifts give access to upper floors. The majority of the bedrooms have en-suite facilities. Rooms are singles or for double occupancy. Two residents only occupy double rooms if they are a couple, or relatives or friends who wish to share. The house is large and spacious, is a listed building and set in extensive, very well maintained grounds. There is ample car parking to the front of the home. The home is well staffed and employs carers, domestic, maintenance and training Care Homes for Older People Page 4 of 24 Over 65 58 0 Brief description of the care home staff. There is a shop/post office approximately two miles away. A bus runs from Hodsoll Street to nearby towns and there are train stations in nearby Meopham and Borough Green. The weekly cost of the service ranges from £404 to £750 per week. Care Homes for Older People Page 5 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This key unannounced inspection took place on Monday 6th July 2009, between 10am and 3pm. During that time the inspector spoke with 7 residents, 3 staff members, and the registered manager as well as the owner and 3 relatives. Feedback was given during and at the end of the inspection. This report contains assessments made from observation, conversation and records, as well as case tracking, and notifications sent to the Commission. The manager returned the Annual Quality Assurance assessment (AQAA) on time, and the information provided has been used in the report. The last key inspection was conducted on the 10th January 2007. Care Homes for Older People Page 6 of 24 What the care home does well: What has improved since the last inspection? 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 7 of 24 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have their needs fully assessed and are assured the home can meet their needs prior to moving in. Residents are supported while making the transition from living in their own homes to living in a care home. Evidence: The records for 2 residents who had moved in recently were looked at, and both these residents were met with. A detailed assessment of care needs had been completed by the manager for both residents and these included spiritual and religious needs as well as social needs and interests. Both residents had been invited to visit the home prior to making the decision to move in and both received the homes service users guides once they moved in. One resident said the moving in process was made much easier by the caring attitude of the staff and manager and also how accommodating the owner is. Both residents had been encouraged to bring in as many of their personal possessions including furniture Care Homes for Older People Page 9 of 24 Evidence: that they wished. One resident said they are wonderful, I couldnt be anywhere better. A resident who had lived at the home for some time said they made the moving in much easier, I was really worried about how it would be not living in my own home, but it was fine, because the staff were so good to me. Holywell Park does not provide intermediate care. Care Homes for Older People Page 10 of 24 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care needs of residents are well managed. Residents are treated with respect and with regard to their privacy and dignity Evidence: The care plans and other documents for 4 residents were looked at and these residents were met with. Many of the care plans had been signed by the residents, and residents spoken with were aware of their care plans and had been involved when staff had drawn them up. The care plans are reviewed by staff on a monthly basis, and more frequently if the residents care needs change. The care plans were detailed and allowed staff to carry out the care the residents need. The daily record could be improved on to include more information about how residents spent their day. Risk assessments are carried out for all residents, in respect of moving and handling and pressure area risk. Falls risk assessments are needed for all residents. Nutritional risk assessments are currently carried out for those deemed vulnerable, the manager agreed to review this and said she will use a professionally recognised tool to screen all residents. The home has purchased some pressure relieving equipment due to the difficulty in accessing equipment through the NHS community store. The home firmly Care Homes for Older People Page 11 of 24 Evidence: believe in preventing pressure sores and the new criteria from the NHS store prevents them from accessing equipment unless a resident has developed a significant sore. Therefore the home has a range of mattresses and cushions for the residents use. The home enjoys good working relationships with the district nurses, who carry out nursing care for residents. All residents are weighed on admission and those who are vulnerable have their weight monitored. Residents have access to a chiropodist who regularly visits the home and was at the home on the day of the visit. Access to hearing and sight tests and other health care professionals is arranged by the home as needed. The home has a medication policy which the staff work to. They use the NOMAD system, and all staff responsible for administering medicines receive training specific to the NOMAD system as well as general medication training. The medication is stored according to good practice guidelines and legislation. Residents who wish to self medicate are assessed by the home and may continue to manage their own medicines if they are able. The manager agreed to make some additions to the self medication risk assessment to ensure all potential areas of difficulty are addressed. Residents said they are assisted by staff to rise and retire at their preferred time, and that they are assisted in a manner sensitive to their needs and with regard to their privacy and dignity. One resident said I dont feel embarrassed they are very good about receiving help with personal care. Care Homes for Older People Page 12 of 24 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents find the lifestyle experienced at Holywell park matches and sometimes surpasses their expectations. Residents enjoy the quality of the meals provided. Evidence: Residents said they are very happy with the activities at the home. A lot of effort is made to incorporate residents interests into the planned programme. There is information on the notice boards for up coming events and planned activities, and residents were aware of how to find out about and join in with activities. The activities planned for the next couple of weeks included card games, skittles, a church service, a pub lunch at the local, and flower arranging. A fortnightly trip is also organised. Activities take place every day, and the home employs a company to visit weekly to carry out motivation sessions. The previous week a group of residents went to a lavender farm, and other recent trips included the cinema to see The Young Victoria, and a trip to the nearby village to see the Meopham Players. One resident is a keen gardener and the owner of the home arranged for some raised beds to be built to enable him to continue gardening. This resident also looks after the homes window boxes. Some relatives regularly get involved with activities and 2 relatives were playing cards with a group of residents on the morning of the Care Homes for Older People Page 13 of 24 Evidence: inspection. The home has 2 large tropical fish tanks and a bird aviary in the garden. Residents can help care for these animals if they wish. Visitors and relatives said that the staff are very welcoming and keen for them to be involved in the running of the home. Residents may see their visitors at any time and in private if they wish. The manager agreed to review how activities are recorded as currently staff are not consistently writing in the daily events what activities residents participated in. Residents are encouraged to maintain their independence for as long as they are able, and they are encouraged to make decisions about what to wear, what they would like to eat, what activities are arranged and many aspects of the running of the home. Regular residents and relatives meetings are held. Residents spoke very positively about the food, one said the food is excellent another said its better than what I made at home. Many of the residents like to eat in the large dining room, and those who need assistance and prefer more privacy may use the smaller dining room next door, residents can eat in their own rooms if they wish. Hot and cold drinks and snacks are provided throughout the day, as well as fresh fruit, and there are water dispensers around the home. Special diets are catered for, the lunch on the day of inspection was beef and mushroom pie, or salmon salad, and apricot compote for pudding. The cooks are employed to work from 8am to 6pm, so all meals are prepared by the cooks rather than care staff, and serving and clearing away is done by the kitchen assistants. The daily menu is written up in the dining room and residents spoken with were aware of what was on the menu that day. Residents may have a cooked breakfast every day if they wish, but most have a full English breakfast on Sunday, recently the manager persuaded the residents to have their roast dinner in the evening and a light snack at lunch time as residents were eating so little of their roasts. However after a short period it was changed back as this was what residents wanted. Care Homes for Older People Page 14 of 24 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are confident that any complaint they make will be taken seriously and acted on. Residents are protected from abuse by the homes policies and procedures. Evidence: The home has a clear complaints policy displayed on notice boards around the home and in each residents bedroom. The policy includes timescales for responding to complaints. Residents spoken with were aware of how to make a complaint and were confident any compliant they had would be dealt with. The manager keeps a written record of complaints made and actions taken to resolve them. The home has received 8 complaints since the last inspection in 2007, all have been resolved to the complianants satisfaction. The complaints included running out of apple juice, and another was around another resident removing clothes from a residents wardrobe. The home takes any complaint seriously and takes action to address any issues. The home has a policy and procedures in place for safeguarding of adults, and whistle blowing. The manager is aware of her responsibilities should an allegation of abuse be made, Staff receive training on induction and regular updated training in the protection of vulnerable adults. Relatives spoken with felt confident and comfortable leaving their loved one in the care of the staff, one said I never worry about mum when I go home, because they take such good care of her Care Homes for Older People Page 15 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have a pleasant, safe and well maintained home in which to live. Evidence: The home is not purpose built but an adapted large country house, the former stables have been adapted into flats, with further rooms above for more independent residents. The owner is going through the process of planning permission for a further 4 rooms which will have adjoining doors so they can be used for couples who wish to share. Giving them the option of sharing a bedroom and using the neighboring room as a living room is they wish. There are 4 lounges one of which is the quiet room, this room has a library. There are 2 dining rooms, and extensive well maintained gardens for residents to enjoy. The assisted bathrooms have a range of equipment to suit a variety of needs. The layout of the home is fairly straight forward and residents were finding their way around the home without assistance. The water temperatures in bathrooms are checked daily and recorded, and the maintenance staff are alerted if the temperature fall outside the set parameters. Residents said they liked their bedrooms, and one spoke very positively about the gardens. There are several seating areas with large umbrellas for shade which residents enjoy in good weather. The laundry is set away from kitchen and food preparation areas. The washing machines are those recommended and used in hospitals to prevent the transmission Care Homes for Older People Page 16 of 24 Evidence: of MRSA and C. Difficile. The owner agreed that the laundry is in need of attention as the walls should be easily washable and the floor impermeable, and plans to address this in the near future. Care Homes for Older People Page 17 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The needs of the residents are met by a competent and trained staff group. The recruitment practices of the home help protect residents. Evidence: The manager keeps a written staff rota showing what staff are on duty and their role. The manager is also on the rota showing when she is available. There is a stable staff team, and turnover is low. Additional staff are on duty at peak times during the day. The care staff are only expected to undertake caring duties, they do not prepare any meals, serve or clear meals, this is done by the cook and kitchen assistants. Care staff do not make beds, clean, or work in the laundry, additional staff are employed for these roles. There are 3 maintenance staff, and the owner is also on site most days. The AQAA states that 17 of the 28 care staff have attained NVQs at level 2 or 3, and more are working toward NVQ. All staff receive regular training in core areas such as first aid, fire, manual handling, COSHH, infection control, and additional training is sought in dementia, the Mental Health Act, and other areas. 3 staff were spoken with, including a newly recruited member of staff. All had completed an application form, had an interview, provided references and undergone police checks prior to starting work. All said they received a thorough induction and ongoing training and updates All said they felt that staffing levels were good, and that they had enough time to meet the needs of the residents. The staff felt supported by Care Homes for Older People Page 18 of 24 Evidence: the manager. The AQAA states that all new staff have an extended induction with a named mentor. The recruitment and training files show that the home works to its policies and safely recruits staff. Care Homes for Older People Page 19 of 24 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a well managed home, run in the best interests of the residents. Evidence: The Manager has worked at the home for many years, and was registered as manager over a year ago. The manager has achieved the Registered Managers Award and is looking into starting a degree in care. There are clear lines of accountability and a deputy has recently been employed to assist the manager. The staff and residents spoke very positively about the manager and the support she provides, all residents spoken with knew her by name, one said shes marvelous if you want anything shell get it for you another said shes wonderful, she cant do enough for you. The home is family run and the owner works at the home most of the week, the residents spoken with referred to the owner by name and also said how kind and helpful he is. The home has quality assurance systems in place, surveys are sent out to residents and their relatives, and regular meetings are held for residents and relatives. The manager is auditing accidents and complaints to look for trends. Formal audits of Care Homes for Older People Page 20 of 24 Evidence: other documentation will feed into the quality assurance system once completed. The manager looks after money for some of the service users, the money is kept separately and securely and with separate balance sheets. Staff receive regular training in moving and handling, fire safety, first aid, food hygiene, and infection control, and policies are in place. Arrangements are in place for servicing of equipment, and maintenance of electrical equipment etc. Environmental risk assessments are in place and the manager regularly walks the patch to address any health and safety issues arising. Care Homes for Older People Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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