Care Home: The Hollies

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What the care home does well The Hollies provides residents with a good standard of care in a comfortable and homely environment. The manager and care staff are clearly committed in providing a sensitive, friendly and professional service to meet the care and support needs of residents. Relatives are made to feel welcome and they confirmed that the care and support is consistently maintained at high standard. Service users have comfortable individual bedrooms, which can be personalised to meet individual tastes and preferences. Activities are regularly planned and the privacy and dignity of service users are promoted at all times. What has improved since the last inspection? The work to provide a new dining area has been completed to a high standard. The increased space provides greater comfort for residents and the room can also be used for visitors to meet with their relatives. A number of improvements to the premises and gardens have also been made (see details in the Environment section of this report) Care plans have been reorganised to provide greater detail and guidelines for staff. Improvements have been made to the recording and administration of medication in the home since the last inspection. What the care home could do better: Care plans would benefit from being in a more person centred style to reflect the social needs of residents. CARE HOMES FOR OLDER PEOPLE The Hollies 11 Queen Edith`s Way Cambridge CB1 7PH Lead Inspector Andy Green Unannounced Inspection 10th July 2008 10:00 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 The Hollies DS0000015232.V368170.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. The Hollies DS0000015232.V368170.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Hollies Address 11 Queen Edith`s Way Cambridge CB1 7PH 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) 01223 245774 01223 414077 holliescarecambridge@hotmail.com Guy Curtis Care Limited Sandra Catherine Margaret Bailey Care Home 22 Category(ies) of Dementia - over 65 years of age (4), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (4), Old age, not falling within any other category (22), Physical disability (1) The Hollies DS0000015232.V368170.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 4 DEE, 4 MDE subject to a maximum total from these 2 client groups combined of not more than six of the total 22 residents and 1 PD. 30th November 2007 Date of last inspection Brief Description of the Service: The Hollies is a residential service for older people over 65. The home provides accommodation for up to 22 service users, some of whom may have dementia care needs. The home is situated in an established residential area on the outskirts of the city of Cambridge. It is within easy reach of the city centre, Addenbrookes Hospital and close to good road and rail links. The home provides accommodation on two floors and there is a passenger lift providing access to the first floor. All of the bedrooms are offered as single occupancy with ten having en-suite facilities. There are adequate bathroom facilities available. The home offers generous communal space with two separate lounge areas and a large dining room. There are attractively maintained gardens to the front and rear of the property. The charges range from £580 - £650 per week CSCI reports are made available to residents and relatives on request. The Hollies DS0000015232.V368170.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 star. This means the people who use this service experience good quality outcomes. CSCI undertook a key unannounced inspection on 10th July 2008. We inspected a number of records including care plans, training records, health and safety records and staff files. A tour of the building and grounds was also undertaken. Six residents were spoken with to gain their views of the support they receive in the home. Three members of staff were interviewed to gather their views regarding the service, training and support they receive. The Annual Quality Assurance Assessment (AQAA) was completed by the manager of the home. This a self assessment process that focuses on how outcomes are being met for people who use the service. Comment cards were also received from residents, staff and relatives. What the service does well: What has improved since the last inspection? The work to provide a new dining area has been completed to a high standard. The increased space provides greater comfort for residents and the room can also be used for visitors to meet with their relatives. A number of improvements to the premises and gardens have also been made (see details in the Environment section of this report) Care plans have been reorganised to provide greater detail and guidelines for staff. Improvements have been made to the recording and administration of medication in the home since the last inspection. The Hollies DS0000015232.V368170.R01.S.doc Version 5.2 Page 6 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 DS0000015232.V368170.R01.S.doc Version 5.2 Page 7 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 The Hollies DS0000015232.V368170.R01.S.doc Version 5.2 Page 8 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): 3,6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager ensures that appropriate information is sought prior to a resident being admitted to the home. Prospective residents and their relatives have access to good information, and can make an informed choice regarding the home’s services EVIDENCE: The manager and a senior member of the care team continue to visit prospective residents to carry out a pre admission assessment. Evidence of a recent assessment was seen during the inspection. The manager stated that there have been no changes made to the assessment procedure since the last inspection however, she stated that the assessment process is reviewed throughout the year to ensure its effectiveness and that appropriate information is received. Prospective residents and their family/relatives continue to visit as part of the assessment process and when they move in to the home. This was confirmed by relatives met during the inspection. The home does not provide intermediate care. The Hollies DS0000015232.V368170.R01.S.doc Version 5.2 Page 9 The Hollies DS0000015232.V368170.R01.S.doc Version 5.2 Page 10 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. Residents receive appropriate health and personal care to meet their assessed needs. Medication is administered and recorded accurately. EVIDENCE: Since the last inspection the manager has reviewed the care planning process in the home in conjunction with a trainer/nursing adviser. Improvements in recording and guidelines for staff have been implemented. Senior carers are also involved in completing care plans. Three care plans were inspected and they contained a variety of information regarding the individual residents assessed needs. Care plans included detailed personal care guidelines, a personal profile, mobility assessments, pressure sore care and nutritional assessments. There was clear evidence that regular monthly reviews are carried out with any changes in care documented with dates and signatures. Relatives are consulted and made aware of any changes in care. The Hollies DS0000015232.V368170.R01.S.doc Version 5.2 Page 11 It would be beneficial if the care plans reflected a more person centred approach to record how preferences, activities, dignity and respect are achieved. Through observation there was clear evidence that care and support is respectfully delivered. The inspectors were impressed with the way a resident was being sensitively assisted by a member of staff whilst using a hoist. Another resident was very pleased that she had her own phone in her bedroom so that she could make or receive calls privately. The manager agreed to look at ways that a more person centred approach could be implemented and she will discuss this with her senior carers and through her contact with the training/nurse advisor. Residents continue to receive visits as required from a variety of healthcare professional including GP’s, district nurses and a chiropodist to ensure that the healthcare needs of residents are maintained. Records of visits from healthcare professionals are recorded in care plans and evidence of this was seen in the three care plans that were inspected. Two relatives of residents spoken to confirmed that they were always informed of any significant healthcare changes. Comments received in a number of surveys from relatives were positive and complimentary about the care and support provided in the home. Comments included, “We are very satisfied with all aspects of the care provide. The staff are exceptional” “I feel that the staff could not have done more to meet the needs of my mother” “Any small problems are quickly rectified” “We couldn’t have found a better home for our mother” “The home makes the residents feel secure and as if they were part of a family” “The home does everything in their power to make my aunt comfortable so that she can enjoy the maximum amount of quality of life possible” One relative met during the day said that she could now sleep easily in the knowledge that her father was being well cared for. Improvements have been made to the recording and administration of medication in the home since the last inspection. The manager has implemented a weekly monitoring book to ensure that the administration of medication is regularly audited. Medication administration records were inspected and were accurate. Controlled medication is stored securely and administration records are double signed in a separate book. One resident administers her own inhaler and she is supported by staff when needed. The Hollies DS0000015232.V368170.R01.S.doc Version 5.2 Page 12 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. Staff provide appropriate support to ensure that residents have access to activities appropriate to their needs. EVIDENCE: A variety of activities are provided throughout the year. Activities include; manicures, chair aerobics, music sessions and flower arranging. Birthday parties and summer fetes continue to be organised. A successful thirties themed garden fete was recently held and photographs of the event were displayed near the front entrance. A full programme of Christmas events are also planned. A music session was in full swing in the lounge, which was being enjoyed by a number of residents. The manager stated that the cook has taken on the delegated task of coordinating activities for individual and group activities in the home. Surveys received from residents and relatives confirmed that there were regular activities and that they were free to participate or not if they wished. Relatives continue to visit regularly. This was clearly evident during the inspection with a number of relatives visiting in the lounge or in the resident’s bedroom. The home has a happy and homely atmosphere and residents and staff were socialising with each other in the lounge. The Hollies DS0000015232.V368170.R01.S.doc Version 5.2 Page 13 A monthly newsletter also continues to be circulated in the home, and to relatives, which gives details of forthcoming events in the home. Resident/relatives meetings are arranged but the frequency needs to be increased. The manager stated that she hopes to organise six-monthly meetings in the near future. It was also suggested that the manager delegates the task of researching daytrips to nearby amenities, to a member of the care staff. This would improve choices for residents who would like the opportunity to have time away from the home if they so wished. There is a varied range of meals offered throughout the day and residents have a choice of alternatives to the suggested menu choices. Daily menus are displayed in the dining room. The cook is aware of any special dies that are required and these are listed in the kitchen. Snacks and drinks continue to be made available at all times during the day. Residents and relatives spoken to confirmed that the food was plentiful and of good quality. The Hollies DS0000015232.V368170.R01.S.doc Version 5.2 Page 14 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. The home has a complaints process to ensure that residents have their complaints and concerns listened to and acted upon properly. Residents are protected from abuse. EVIDENCE: The home has a clear complaints procedure, which ensures that all complaints are fully investigated and actioned appropriately. The home has not received any complaints since the last inspection. CSCI has also not received any complaints regarding the home. The home has a policy regarding Safeguarding Adults, which is in line with the Local Authority policies. Care staff confirmed that they had received Safeguarding training and it was clear from conversations that they would have no hesitation in reporting any incidents or allegations of abuse. It was clear through observations that the care team are committed to the care of residents. They were observed to speak in a respectful, sensitive and friendly manner. Relatives spoken to during the inspection also confirmed this to be the case. The Hollies DS0000015232.V368170.R01.S.doc Version 5.2 Page 15 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): 19,23,24,25,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable and well-maintained environment to meet the individual preferences and needs of residents. EVIDENCE: The premises are very well maintained and there is an ongoing maintenance and decoration programme in place. Since the last inspection a number of improvements have been made including; • The work to provide a new dining area has been completed to a high standard. The increased space provides greater comfort for residents and the room can also be used for visitors to meet with their relatives. All bedrooms are provided with Profile beds to aid residents comfort and safety Four bathrooms have been redecorated and refurbished. DS0000015232.V368170.R01.S.doc Version 5.2 Page 16 • • The Hollies • • • Three bedrooms have had ensuite facilities incorporated. The lounge and a number of bedrooms have been redecorated since the last inspection. The gardens near to the lounge have been redeveloped with attractive raised bedded areas. Six bedrooms were seen and residents confirmed that they could bring personal items and furniture and personal items including plants, ornaments and photographs. Bedrooms seen during the inspection were clean, bright, airy and well decorated to meet the resident’s style and preferences. The gardens to the front of the premises continue to be well maintained throughout the year. Residents and their visitors confirmed that they enjoyed spending time in the gardens. The home was clean and bright in the communal areas and free from any smells or odours. The Hollies DS0000015232.V368170.R01.S.doc Version 5.2 Page 17 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. The home’s recruitment and training processes ensures that residents receive care from a competent care team and that they are protected from harm. EVIDENCE: Two staff files were inspected. There was clear evidence that a thorough recruitment procedure is in place. An application form, CRB/POVA checks and references are received before employment commences. This was seen in both files inspected. Staff spoken to stated that they had received a good induction. There are three carers on each shift along with the manager, administrative staff and two carers at night. There are domestic staff and one cook working in the home each day including weekends. The manager stated that there are vacancies at present and she was actively recruiting. Agency staff are used to fill any shortfalls and there is usually one agency worker used each day. The home’s training files were inspected and there was clear evidence that staff continue to regularly receive a variety of training throughout the year. Staff confirmed that they had received a number of training and updates including; Safeguarding Adults, moving and handling, fire safety, infection control, health and safety, effective communication, challenging behaviour and first aid. The Hollies DS0000015232.V368170.R01.S.doc Version 5.2 Page 18 The manager is in the process of organising further training Records and Care planning and Dementia training. Evidence of up to date training certificates were seen in staff file. The manager stated that the majority staff had completed or were working towards NVQ at levels 2 & 3. courses. All of the senior carers had achieved NVQ at level 3 Comments from staff included; “Good training, and they have helped and developed me as a worker so that I fell confident to do a professional job” “If I thought that I didn’t have the right support or experience I would ask for more training” The Hollies DS0000015232.V368170.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and the manager provides supportive leadership and guidance to staff to ensure that service users receive high quality care. EVIDENCE: The manager continues to provide a clear and inclusive management style in the home. She is experienced and continues to attend training to update her knowledge and skills. She is an NVQ Assessor and provides ongoing support to staff in the home. Staff spoken to during the inspection confirmed that they were well supported by the management in the home. The frequency of staff supervision has improved since the last inspection to ensure that staff receive at least six recorded sessions during the year as recommended in the National Minimum Standards. Evidence of recorded sessions was seen in files kept confidentially by the manager. The Hollies DS0000015232.V368170.R01.S.doc Version 5.2 Page 20 The provider is actively involved in the home on a daily basis and provides continuing support to the manager, administrative staff and residents. A quality assurance process is in place and report from recent surveys were seen during the inspection. Two of the service users personal money and records were inspected and were accurate. A new fire alarm system has been installed in the home and accurate records fire alarm/emergency lighting testing was seen. A new call system has also been iinstalled which has proved to be successful. The system also incorporates added security to the front door and other external entrances. There are contracts in place for equipment /maintenance checks throughout the year. The Hollies DS0000015232.V368170.R01.S.doc Version 5.2 Page 21 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 X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 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 3 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 X 3 3 X 3 The Hollies DS0000015232.V368170.R01.S.doc Version 5.2 Page 22 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. 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. Refer to Standard Good Practice Recommendations The Hollies DS0000015232.V368170.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Hollies DS0000015232.V368170.R01.S.doc Version 5.2 Page 24 - 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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