Care Home: The Hollies Nursing & Residential Home

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What the care home does well This unannounced inspection visit did not look at all the aspects of care provided at The Hollies. However no evidence was seen during the visit to suggest that any standards of care had deteriorated since the last key inspection. Staff are kept up to date about the changing needs of service users which helps to ensure that those needs are appropriately met. Service users and, where appropriate, relatives are involved in discussions and decisions around their care needs and were very positive about the competency and attitude of the staff team. Service users are able to have access to the full range of health care available in the community. Medication is safely stored and handled to ensure, as far as is possible, the good health of service users. The staff team create an atmosphere where service users and their relatives feel confident that they could complain if they needed to and that any complaint would be appropriately dealt with. Similarly the staff team enable service users to feel safe living at the home. What the care home could do better: Potential improvements which were identified at this inspection visit related to some areas of administration and record-keeping. This did not appear to have an immediate detrimental impact on any service user, but could make it harder for the home to demonstrate fully the high standard of care provided. If an assessment "tool" is used the outcome of the assessment should be clearly recorded to identify what action has been decided upon as a consequence of the assessment. Records should be maintained to demonstrate that the agreed ways of meeting identified needs are being undertaken. Better recording of minor and informal complaints may identified areas where the service could be further improved and would help to demonstrate that the management of the home are receptive and willing to receive and resolve concerns. Random inspection report Care homes for older people Name: Address: The Hollies Nursing & Residential Home The Grange Church Street Clayton-le-moors Accrington Lancashire BB5 5HT three star excellent service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Steve Chick Date: 2 6 0 5 2 0 1 0 Information about the care home Name of care home: Address: The Hollies Nursing & Residential Home The Grange Church Street Clayton-le-moors Accrington Lancashire BB5 5HT 01254381519 01254395477 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Margaret Holden Type of registration: Number of places registered: Conditions of registration: Category(ies) : The Hollies Nursing & Residential Home Limited care home 39 Number of places (if applicable): Under 65 Over 65 0 32 0 dementia old age, not falling within any other category physical disability Conditions of registration: 7 0 32 The maximum number of service users who can can be accommodated is: 39 The registered person may provide the following categories of service only: Care home with Nursing - code N To service users of the following gender: Either Whose primary care needs on admission to the home are within the follwing categories: Old age, not falling within any other category - code OP (32) Physical Disability - code PD (32) Dementia - code DE (7) Date of last inspection Care Homes for Older People Page 2 of 9 Brief description of the care home The Hollies provides 24 hour nursing and personal care for up to 39 people. The registered providers are The Hollies Nursing & Residential Home Ltd. The day-to day management of the home is undertaken by one of the registered persons and there is a Registered Nurse who takes responsibility for the care management of the residents. The home is situated in Clayton-Le-Moors close to local amenities including a park. The home is a large detached property with gardens, which are easily accessible to all service users. A parking area is available for use by visitors and staff. Accommodation is provided in single or twin-bedded rooms. There are no en-suite rooms but toilet and bathroom facilities are within easy reach of all rooms. A passenger and stair lift facilitates access to all areas of the home. Communal lounges and dining rooms are located on the ground floor. Information is available about the home in a Statement of Purpose and Service User?s Guide. As at May 2010 the fees ranged from £360.00 - £544.00 per week, depending on the level of care needed. Items not covered by the fee included: Hairdressing; Clothing; Private chiropody; Toiletries; Newspapers; and holidays. Care Homes for Older People Page 3 of 9 What we found: We conducted a random inspection of the Hollies on the 26th of May 2010 as part of our regulatory responsibility. We did this to see if there had been any significant changes in the delivery of the services provided and if any of those changes impacted negatively on the service users or affected the quality rating given that the last key inspection in June 2007. At the last key inspection, the quality rating given to the service was 3 star. This means the people who used the service were experiencing excellent quality outcomes. Since that time we have asked the registered provider to complete an Annual Quality Assurance Audit (AQAA) each year. The AQAA is self-assessment document that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information. We have also undertaken an annual service review (ASR) each year since the last key inspection. An ASR does not involve a visit to the service, but is a summary of new information given to us, or collected by us, since the last key inspection or annual service review. We had received completed surveys from seven staff and nine service users. This random inspection was unannounced and focused mainly on outcomes for service users in connection with their health and personal care, and the way in which the home manages complaints and protects the people who live there. We interviewed in private, three service users, two staff, four relatives and one other visitor. We also spoke to the care manager who was the senior person on duty at the time of the visit. We looked at a sample of records relating to health and personal care of service users, and complaints and protection. All service users files we looked at had a written care plan with good documentary evidence that the plan was regularly reviewed and when necessary, updated to reflect any changing circumstances. Staff sometimes used specific assessment tools to help assess the risk to a specific individual. These comprise a form, where specific numbers are allocated for identified issues, which, when added up, give a total score. This score can then be used to identify the level of risk, and consequent action needed to lessen the risk. These were in use, for example, to help assess the risk of pressure areas developing, the risk of falls or the risk of malnutrition. The effective use of these tools seemed inconsistent. One example was seen where a certain level of risk was identified, which had prompted a plan which was implemented and well recorded. Another prompted a plan which we were told was being followed, but which was not so well recorded. Another example was seen which had identified a degree of risk, but this did not seem to have resulted in a specific plan. Discussion with service users, relatives and staff, indicated that these inconsistencies related to the records and not the quality of care which was being provided. Staff who we asked, told us that the overall system for keeping them up to date with the changing needs of individuals worked well. This included detailed verbal information at each change shift as well as the written records. Staff who returned a survey to us all reported positively on the standard of care provided. Care Homes for Older People Page 4 of 9 Service users and visitors who we talked to were all positive about the care provided. Those who we asked, also told us that they were involved in discussions about how their (or their relatives) care needs were to be met, and could influence the way staff worked with them. One relative told us that they remembered being asked if anything needed to be added to the care plan before it was agreed. All service users and relatives who we asked, said that people had their dignity and privacy maintained and were treated respectfully. One visitor was particularly pleased with the way in which their relative had their pride maintained through always being well dressed. Staff were described by service users and relatives as: very good, [they] always have a smile ... very kind ... very gentle; good people; all the staff have been very nice and helpful towards me; care is excellent, nothing is too much trouble. There was good documentary evidence that people living at The Hollies have access to the full range of health care available in the community. Service users, relatives and staff, told us that they were confident that medical support was obtained, if necessary, and in a timely manner. Medication presented as being appropriately and securely stored, including controlled drugs (medicines which can be misused) and medication requiring specific temperature control. We looked at a small sample of medication administration records, which presented as being well maintained. The records demonstrated that the right dose of the right medication had been given to the right person at the right time. The home had a written complaints procedure which was seen to be displayed in the main corridor of the building. We were also told that each service user had a copy of the homes service user guide, which contained the complaints procedure. In spite of this, four service users who returned a survey to us (nearly half) said they did not know about the complaints procedure. They did however, also tell us that they knew who to talk to if they were not happy. Service users and visitors who we asked, were all confident that any complaint could be raised and that it would be dealt with. One visitor said that staff are very approachable which made talking to them easy. It was clear from talking to staff and visitors that sometimes little things do go wrong, or are overlooked and that, when identified, they are always and quickly put right. We did not look at the complaints log as we were told there were no complaints recorded, other than one formal complaint which had just been received by the home and was being investigated at the time of this visit. Discussion with the care manager indicated that the complaints log was used only for formal written complaints, not informal expressions of temporary dissatisfaction which are quickly resolved. We discussed the value of the central record of even informal complaints or comments, which could be used both to identify any patterns which may indicate how the service could be further improved, and to demonstrate the homes openness and willingness to receive and resolve concerns. We were told that all staff had received training in the protection of vulnerable adults (POVA). We looked at the homes training matrix which confirmed this, as did staff who we asked. Staff who we spoke to understood the need to be vigilant about the possibility of service users being vulnerable to abuse or exploitation. Staff also told us they were aware of their responsibility to whistle blow if necessary. Care Homes for Older People Page 5 of 9 All service users and visitors who we asked, said that people living at The Hollies were safe. One visitor said I would not have let [my relative] come here if I had any doubts, another said Im putting my name down for The Hollies and a service user told us that they felt very safe because the staff were wonderful. What the care home does well: What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 6 of 9 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 9 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 7 The responsible individual shoud ensure that records are maintained to demonstrate that the agreed ways of meeting identified needs are being undertaken. The responsible individual should ensure that when an assessment tool is used the outcome of the assessment is clearly recorded to identify what action has been decided upon as a consequence of the assessment. The responsible individual shoud ensure that minor and informal complaints are recorded in a way that may help management to identified areas where the service could be further improved. 2 7 3 16 Care Homes for Older People Page 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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