Care Home: The Hollies

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What the care home does well The Hollies is comfortable and homely. It offers service users a family style place to live. The owners know the people well and understand how to care for them and promote their independence and well being. People who live at the home spend a lot of time in France, at the owners` property there. Service users enjoy this lifestyle and have made new friends as a result. A healthy diet is offered to service users and advice given on healthy eating and exercise. The care is very family orientated and all the people living there have lived there many years. The family of the owners are seen as the extended family of the people who live there as none of them have close family of their own.There is equipment available to help people live an independent lifestyle. What has improved since the last inspection? People continue to take part in some activities that could create risks to their health and safety. Risk assessments have been put in place so that people`s well being is promoted. Records of the food eaten by people are not kept. However, there is evidence that there is fresh food products in the home and people receive a varied diet. What the care home could do better: The owners operate a very family orientated service and this is good for the people who live there. However, they must also that they are a registered service and must make sure that basic information and records are available for them to remain a good service. CARE HOME ADULTS 18-65 The Hollies 109 Coleshill Road Marston Green Solihull West Midlands B37 7HT Lead Inspector Ashley Fawthrop Key Unannounced Inspection 20th March 2008 10:00 The Hollies DS0000004552.V348077.R01.S.doc Version 5.2 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 The Hollies DS0000004552.V348077.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 Adults 18-65. 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. The Hollies DS0000004552.V348077.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Hollies Address 109 Coleshill Road Marston Green Solihull West Midlands B37 7HT 0121 779 2557 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) Mr Tony Rooke Mr Tony Rooke Care Home 3 Category(ies) of Learning disability (3) registration, with number of places The Hollies DS0000004552.V348077.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th February 2007 Brief Description of the Service: The Hollies is a family home that is registered as a care home for three younger adults who have a learning disability. Mr Rooke is the registered person, assisted by his wife. They provide all the support and care for the residents and no staff are employed. Mr and Mrs Rooke live at the home, which operates very much as an Adult Placement Care Home, but cannot be designated as one, owing to the lack of an Adult Placement scheme in Solihull. The home is an attractive detached house on the main road of the residential area of Marston Green and is in keeping with neighbouring homes. It is situated approximately 3/4 mile away from the local shops and is close to public transport routes. The home has a large and private garden at the rear. An extension to the home is being built, which will offer more living space to Mr and Mrs Rooke and the service users. Mr and Mrs Rooke also have a property in France. Use of this is an important part of their lives, and that of the service users. The contrast between life in a residential suburb in the West Midlands, and in a rural part of France, enables service users to have a greater number of opportunities and experiences than they might otherwise have. The home charges £350 - £450 a week of which service users contribute an amount from their welfare benefit. There are no additional charges for any services. The Hollies DS0000004552.V348077.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means that people using this service experience good quality outcomes. This fieldwork took place over half a day and was the home’s key inspection for the year. The visit was unannounced and the visit included looking at a range of records relating to the care, protection of people and health and safety. Speaking to the owners and people who live at the home. The owners wrote down things about health and safety in the home and the support they give to service users. This helps the inspector understand how the home is run. Bedrooms, the lounge, kitchen and bathroom were looked at to make sure they were clean and safe for service users. Records that explain how service users are cared for were read and the owners talked about the way they help service users make choices and be involved in the routines within the home. There were no immediate requirements made as a result of this visit. What the service does well: The Hollies is comfortable and homely. It offers service users a family style place to live. The owners know the people well and understand how to care for them and promote their independence and well being. People who live at the home spend a lot of time in France, at the owners’ property there. Service users enjoy this lifestyle and have made new friends as a result. A healthy diet is offered to service users and advice given on healthy eating and exercise. The care is very family orientated and all the people living there have lived there many years. The family of the owners are seen as the extended family of the people who live there as none of them have close family of their own. The Hollies DS0000004552.V348077.R01.S.doc Version 5.2 Page 6 There is equipment available to help people live an independent lifestyle. What has improved since the last inspection? 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. The Hollies DS0000004552.V348077.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Hollies DS0000004552.V348077.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 People using the service experience good quality outcomes in this area This judgement has been made using available evidence including a visit to this service. People have had their needs are assessed before they move in so they can be confident that the home can meet their needs. EVIDENCE: It has been some years since the last person moved into the home. The home has no vacancies and the owners confirmed that it was highly unlikely they would offer a placement to a new service user should a vacancy arise. All placements have been arranged by a Social or Health Care professional following a period of assessment and trial visits. Evidence was seen in people’s records that their placements at the Hollies continue to be monitored each year by the funding agency to make sure that the home meets their individual needs. The Hollies DS0000004552.V348077.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 People using the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Individual care is planned for and understood by the home’s owners. Risk assessments have improved since the last inspection but the owners must continue to assess any new risks. EVIDENCE: People have a care plan, which describes the support they need to maintain and develop their independence. An officer from Solihull Care Trust, reviews the care plans with the input from the registered owners, this is done on a yearly basis. The owners demonstrated considerable knowledge of people’s needs and understanding of their role in supporting individuals to self care where this is appropriate to their assessed needs. The Hollies DS0000004552.V348077.R01.S.doc Version 5.2 Page 10 Risk assessments continue to be in place to describe the controls needed to minimise potential risk to people. Development of the risk assessments continue to include those activities undertaken by people when they holiday in France (i.e.) cycling and swimming, so that their health and well being is promoted and protected whilst they are there. The owners need to update assessments when new risks are identified. On the day of the visit there was one person in the home who got up with minimal assistance she had a choice of breakfast and assisted with preparing this. This is evidence that people have control in their lives and have the opportunity to make decisions. The Hollies DS0000004552.V348077.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 and 17 People using the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People experience a meaningful lifestyle and take part in activities that promote their independence. EVIDENCE: Two people attend a local day centre and work placement during weekdays, whilst another receives support to access community based activities directly from the home. These continue to include visiting the owner’s relatives, shopping, walking the family dog, trips to the park and café’s for coffee. Risk assessments continue to be in place for people that travel independently to a work placement to promote his safety whilst travelling. The Hollies DS0000004552.V348077.R01.S.doc Version 5.2 Page 12 There were a number of photographs of people taking part in activities displayed around the home. People also have photograph albums that are personal to them and kept in their bedrooms. The activities are very family orientated and ranged from gardening, boating and cooking to trips to Austria, France and Italy. The owners continue to have a property in rural France where they and the service users spend about four or five months each year. People who live at the home and owners enjoy varied activities while they are in France they go for walks, go fishing, have barbecues and spend time with their friends in the village. Mr Rook said that people have more change to do activities like riding bikes as the home is in a rural setting and there was less traffic. People living at the home have learned a few words of French to help them communicate with their friends in France. Arrangements have been made so that in the event Mr or Mrs Rooke is unable to care for people in France as a result of an accident or emergency, there are English-speaking friends living nearby who can respond quickly. The local doctor lives 500 yards from the property so that if anyone is unwell they have access to his services. The owners were keen to stress that this had never occurred. The owners commented that there had never been a situation where people said they didn’t wish to go to the house in France, however if this did occur arrangements would be made for them to remain at home with a carer. None of the people living at the home have family members that keep in touch with them, the owners said that they and their family were the extended family of the people living at the home and it was explained that this was largely due to the considerable amount of time the person had lived in the home and the ethos of care as a family home. From observation of the people present at this visit, it was evident that the person’s independence was encouraged. People getting up when they wish and helping with preparing meals evidenced this. The home continues not have a formal menu, which is recorded. Instead people choose what they want to eat from the weekly shop. People have opportunities to go food shopping and do some cooking. The owners demonstrated a sensitive approach to helping a people take part in The Hollies DS0000004552.V348077.R01.S.doc Version 5.2 Page 13 food shopping by choosing smaller supermarkets as large spaces and crowds increase the person’s anxiety. The inspector was told that no specific diets are required and that service users have food that is reflective of their cultural background, such as roast Sunday lunches. No records of food consumed by people are kept. However, there was evidence that fresh products were available and that people have a varied diet. The Hollies DS0000004552.V348077.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 People using the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Appropriate arrangements are in place to make sure that people receive personal support in the way they prefer and require and their health needs are met. EVIDENCE: Individual’s personal and health care records were sampled. There was evidence that people attend regular dental and optician appointments and see their local GP as needed. The owners described providing a nutritious diet and encouraging regular exercise as a means of promoting a healthy lifestyle. The person present at this visit had clearly been supported with personal care and was considered well dressed, in keeping with the person’s age and gender. No prescribed medicines are needed by any one. This was the same as at the last inspection. One of the owners has completed training in the administration The Hollies DS0000004552.V348077.R01.S.doc Version 5.2 Page 15 of medicines to develop her skills in the event that service users require prescribed medicines in the future. The Hollies DS0000004552.V348077.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People using the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. There are satisfactory arrangements in place for people to make complaints and safeguard them from potential harm. EVIDENCE: “How to Complain” leaflets issued by Solihull Care Trust continue to be made available to people. There have been no complaints about the home in the last twelve months. The owners have many years experience with working with young people and have had training in child protection in the past. They were able to describe circumstances under which they would seek professional guidance in the event that people’s behaviour changed which might indicate a need to review the service provided in the home. The Hollies DS0000004552.V348077.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 29 and 30 People using the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People live in a comfortable, homely and pleasant environment, with facilities available to meet their individual needs and promote their independence. EVIDENCE: The Hollies is a spacious, detached house situated close to the shopping areas of Marston Green and Chelmsley Wood. There are bus routes close by, which meet the needs of people that travel independently. The home is no different to other properties in the area and is well presented, decorated and furnished. The Hollies DS0000004552.V348077.R01.S.doc Version 5.2 Page 18 Shared areas consist of a lounge and through dining room with a separate kitchen. The dining room has sufficient space for the owners and people to eat together. People have their own bedroom, one of which has an en suite bathroom. Bedrooms were clean and warm, well furnished and reflective of people’s personalities and tastes. This gives a feel of individuality and ownership. Since the last inspection the ground floor bedroom was has been redecorated, the work took place whilst they were in France to minimise disruption to the person. There are facilities for people with mobility difficulties to bathe safely in the ground floor bathroom, with grab rails positioned to promote the person’s independence. Evidence was seen that bathing equipment had been serviced as safe to use within the last five months for the protection of those using it. The kitchen was observed to be clean and hygienic. Temperatures of refrigerated and frozen foods are recorded to avoid risks of food contamination for service users health and well being. The Hollies DS0000004552.V348077.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 People using the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People receive good support from the owners of the home so that their individual needs are understood and met. EVIDENCE: The owners, Mr and Mrs Rooke live at the home and provide all the care to people. No staff are employed. In the event that the owners take a break from caring, which was described as infrequent, support is provided to people at the home by a family member who is a registered care manager and has known the people living in the home for many years. The owners have completed recent training in First Aid, Moving and Handling and Medicines Management. Mrs Rooke described receiving health and social care magazines as a means of keeping up to date in the field of care work. The Hollies DS0000004552.V348077.R01.S.doc Version 5.2 Page 20 From observation of service users interaction with the owners, it was clear that respectful and meaningful relationships had been formed. The owners demonstrate considerable knowledge of service users needs and understand their role in supporting service users to maintain and develop their independence. The Hollies DS0000004552.V348077.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 People using the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is well managed and people’s health and safety is promoted and protected. EVIDENCE: The owners have run the home for seventeen years, having prior to 2001, been part of an Adult Placement (AP) Scheme. The owners have very much maintained the ethos of an AP style service to the people who live in the home, including them in family life and decision making. Whilst there is no formal quality assurance system, service users comments about their involvement in the running of the home were very positive. “We The Hollies DS0000004552.V348077.R01.S.doc Version 5.2 Page 22 make our choices together, like a family does” and “I get lots of things done by myself. This is important to me”. People’s placements at the home are reviewed each year by a multi disciplinary team of people that have contact with them, including the owners, day centre and work placement staff, health and social care professionals. The owners have completed periodic training to assist their care of service users, such as First Aid and Moving and Handling. The premises are a home to both the owners and the people who live there it is a family home and is maintained as such. Health and safety is taken into account as they are in any family home and as such domestic smoke detectors are in place and water temperatures are set to a safe limit to prevent people from scalding. Weekly tests of the smoke alarms continue to be made and recorded to make sure that the system is working for the safety of those in the home. The home has a fire escape plan, which is kept at the local fire station so that in the event of an emergency the fire service are aware of the layout of the premises and the location of fire exits. Certificates were in place for the maintenance of portable electrical appliances and the electrical hardwiring system, dated January 2007, to show they had been checked for safety. The Hollies DS0000004552.V348077.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 2 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 X 28 X 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X The Hollies DS0000004552.V348077.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? 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. Standard Regulation Requirement Timescale for action 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 YA9 Good Practice Recommendations Risk assessments must be developed and implemented to clearly state the controls in place to manage known hazards associated with activities that individuals take part in whilst in France. Records of the food consumed by each service user must be maintained in sufficient detail to enable it to be established that a varied and nutritious diet is provided. 2 YA17 The Hollies DS0000004552.V348077.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection West Midlands 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. Extracts may not be used or reproduced without the express permission of CSCI The Hollies DS0000004552.V348077.R01.S.doc Version 5.2 Page 26 - 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. 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