Inspection on 27/07/09 for Shenleybury House

This is the latest available inspection report for this service, carried out on 27th July 2009.

CQC found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Shenleybury House 09/01/06

Shenleybury House 25/10/05

Shenleybury House 22/02/05

Shenleybury House 11/10/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Shenleybury House Black Lion Hill Shenley Hertfordshire WD7 9DE     The quality rating for this care home is:   three star excellent service 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sheila Knopp     Date: 2 7 0 7 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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 26 Information about the care home Name of care home: Address: Shenleybury House Black Lion Hill Shenley Hertfordshire WD7 9DE 01923859238 01923859398 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Shenleybury House Limited care home 15 Number of places (if applicable): Under 65 Over 65 15 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 0 Shenleybury House is a residential care home offering accommodation to fifteen older people. It is a pleasant period building, in a rural setting within attractive grounds. The home is situated on the edge of Shenley village. The house is spacious, bright and holds many of its original features. Many of the service users are local people, which gives the home as a pleasant community atmosphere. The home, which affords a safe and comfortable environment for its residents, is privately owned and currently charges fees, which range from £437 to £550 per person per week. Information about the home its Registration and Insurance Certificates along with copies of recent Inspection Reports and a book for Visitors Comments and Suggestions and the companies Complaints Procedure are displayed in the homes entrance hallway. Care Homes for Older People Page 4 of 26 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: The last inspection of this service took place on 15th June 2007 and an Annual Service Review was made on 16th May 2008. This inspection was unannounced and took place over seven hours on a weekday. This was a key inspection that focused on the key standards of the Care Standards Act 2000 relating to Older People. This report is written using accumulated evidence gathered prior to the inspection, including information contained in the AQAA,( Annual Quality Assurance Assessment ) completed by the Manager, information given in the twenty pre-inspection questionnaires completed by residents, staff, relatives and health professionals; and also takes account of statutory notifications sent periodically to the Care Quality Commission by the Manager. The AQAA is a self assessment that focuses on how well care outcomes are being achieved for people living at Shenleybury and Care Homes for Older People Page 5 of 26 also includes some useful statistical information. During this visit we made a tour of the building, had in depth discussions with the homes Manager met and spoke with all the residents and a number of visitors. All the staff on duty were spoken with and spot checks were made on a number of the homes records. 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 set out on page 4. Care Homes for Older People Page 7 of 26 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 8 of 26 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 9 of 26 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. People who use this service can expect to have an assessment of need prior to entering the home and to have the opportunity to assess the service offered. The home does not offer intermediate care. Evidence: Good information about the home and the level of services offered is given to all prospective applicants. People wishing to move into the home will have a full assessment of their care and social needs carried out by the manager or senior care worker who will visit them at their home or in hospital. Relatives or representatives may be involved in this assessment if the applicant wishes them to be. Information from medical and social care services are gathered so that the home can be fully informed about all aspects of the applicants needs. Care Homes for Older People Page 10 of 26 Evidence: The records of two new residents were seen during this inspection and each one had a pre admission assessment fully documented. Areas of need that were covered included personal hygiene, diet, mobility, communication, medication and night care needs. Other information was about behaviour, likes and dislikes and relatives involvement in their care prior to admission. Special needs such as walking aids or a particular chair or bed were also noted and where needed areas of risk appropriately assessed. Information about past medical history and present medication was also included. The home has a brochure which gives clear information in a manner which gave a good insight into life in the home. The Statement of Purpose was up to date and informative containing all the required elements. All the service users have a contract and information concerning terms and conditions of residency. Residents and relatives spoken with said that they had the opportunity to visit the home and assess the service before making the decision to move in. One service user told us I like it here a lot I am very glad I came here. Care Homes for Older People Page 11 of 26 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. People who use this service can expect to have their health and personal needs met in a dignified and respectful manner by staff who have a good knowledge of their care needs and how these should be met. The homes medication policy, procedures and practice protect the service users from risk from any medication error. Evidence: Since the last inspection the home has revised all the care plans into a new more person centered format which gives better details of the assessed care needs and how these should be met. All four plans examined were found to be very well recorded with information in clearly defined sections many of which were signed by the service user thereby giving evidence of their involvement with their compiling. Risk assessments were seen to be regularly reviewed. The plans were found to generally contain a good level of detail about the action required by staff to support the service user to meet their assessed needs. References that reminded staff to assist service users to do as Care Homes for Older People Page 12 of 26 Evidence: much for themselves as they possibly could even if this took a little longer were noted to evidence good practice. Residents who completed pre inspection surveys all felt that they received the care and support that they needed including prompt medical support. Those spoken with during this visit were all happy with the way staff supported them and were fully aware of their care plans and confirmed that they were regularly involved with the plan reviews and were always given the opportunity to sign their plans. Several residents told us how wonderful the staff are. One said nothing is ever too much trouble and I feel secure and very well cared for in this home. During our visit staff were observed knocking on doors before entering bedrooms and bathrooms. Interactions between staff and residents were relaxed friendly and respectful and residents spoken with said that they had no concerns that their dignity would be compromised by poor practice. The care plans contained clear records of contact with other healthcare professionals and a GP visited the home during our visit. A member of the District Nursing service visits each morning to assist one service user. The plans and risk assessments were seen to include evidence of the new requirements concerning the Mental Capacity Act and the Deprivation of Liberty this to ensure that the residents choices are promoted whilst offering them full protection. Part of the medication administration routine at lunchtime was observed. Staff were seen to administer medication in a kindly manner working with the service user at their pace and in a manner that did not interrupt their enjoyment of their meal. The home uses a MDS monitored dosage system for medication which is supplied from a local pharmacy who offer regular training for the home. Since the last inspection the home has a new medication cupboard in a secure setting which has the benefit of air conditioning, medication which needs to be can be kept in a fridge. The medication trolley has a wall security lead. The home has a Controlled Medication cupboard and the records relating to two controlled drugs which were being administered at the time of this visit were found to be correctly kept. Spot checks were made on the MAR charts and no errors were found. It was seen that appropriate identification codes and a written explanation of variations were being fully recorded on the reverse of the sheet. The manager makes regular checks of the accuracy of these administration records and audits are kept of the amount of medication entering and leaving the home. Care Homes for Older People Page 13 of 26 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. People who use this service are encouraged to exercise choice and to have control over their lifestyle. The home offers good facilities to meet their recreational and social needs and enables residents to maintain close links with their family and friends. People who use this service are offered an excellent choice of nutritionally balanced home cooked meals. Evidence: Since the last inspection the range of activities has increased and dedicated activity organizer hours have been introduced in addition to the external organizer who visits the home weekly to lead activities. The residents are regularly consulted about the range of activities in their residents meetings and each one now has a written activities programme and it could be seen that records of their participation in and enjoyment of their chosen activities was also being recorded. On the day of our visit an armchair exercise group was taking place and a small group discussion about holiday memories was observed both these activities being led by the homes regular staff. Two service users were knitting and another told us of the crocheting class that had recently commenced. Two other residents who choose to spend their time alone reading in their Care Homes for Older People Page 14 of 26 Evidence: rooms were seen to be reminded of the BBQ and Pimms Lunch on the patio and the one who chose not to join in with this was never the less bought an appetizing tray of food and drink. It was seen that another service user who did not like BBQ food had a separate meal of their choice,a Jacket potato, prepared for them by the cook. Information in the AQAA (Annual Quality Assurance Appraisal) tells us that the home now has a more structured activity list and evidence of this could be seen from the activities book and from photographic evidence of outings parties and events. It was clear that musical events are very popular and the attendance at church services is also regular. A regular reminiscence group is held and several residents are still able to participate in a spot of gardening. Beauty and pampering sessions were also seen to be much enjoyed. The staff make particularly good efforts to help residents maintain contact with their family and friends. One resident is taken regularly by staff to visit her friend in another area of the county and recently staff accompanied another resident to a local hotel to attend a family wedding. A number of residents told us that they enjoyed trips to the St. Albans market and having a picnic by the lake. Without exception all the service users were very complimentary about the food and said that they were regularly consulted about menu choices and new dishes to try. Staff said that themed food evenings had become very popular with spicy new dishes being suggested by residents who had lived most of their lives abroad being surprisingly well liked. The manager explained that the changed cooking arrangements were working well and the kitchen was found to be well kept and very clean. A weekly menu is planned but being a small home the manager is able to buy the provisions weekly and she consults with residents before doing this so that particular tastes to suit the seasons can be met and variations to the planned menu to meet individual requirements are often made. Care Homes for Older People Page 15 of 26 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. Practices in this home ensure that the people who use the service can be confident that the policies and procedures in place will ensure that if they raise any concerns about the service they will be listened to and taken seriously and they can be confident that they will be protected from abuse. Evidence: The home has a robust and effective complaints procedure and service users and relatives consulted knew who to talk to if they were not happy and wanted to complain. Several said that if they did need to raise any issue they would do so first with the homes manager whom they felt sure would sort things out quickly. One told us that the manager and staff are always very approachable, the manager has an open office door and always visits us all in our rooms to chat with us individually every day. The homes Statement of Purpose gives information about the homes complaints procedure and the expected time frame for any issues to be dealt with. Information about how to access Advocacy Services is also given. The homes training records evidenced that all the staff had recently attended refresher safeguarding and whistle blowing training. Staff spoken with had a good knowledge of the procedures that they should follow if they ever had any cause for concern. An incident of possible concern was discussed during this visit and the manager was able to demonstrate that the correct actions had been taken to ensure the safety of the service user concerned. Care Homes for Older People Page 16 of 26 Evidence: There have been no complaints received since the last inspection. The home keeps a record of Compliments received and these were shown to us during this visit. Care Homes for Older People Page 17 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service live in spacious quality accommodation that provides a safe, comfortable and well maintained environment. The accommodation is homely, clean and hygienic and is very well appointed with the appropriate facilities to meet their assessed needs. Evidence: A tour of the building identified that Shenleybury House is a spacious well appointed home maintained to a high standard. The bedrooms have ensuite facilities and many are large and airy. Decorations are individually chosen and residents were seen to have personalized their rooms with items of their own. All the residents spoken with confirmed that they were very happy with their rooms and the whole home had a very comfortable and homely feel and appearance. One resident explained that although they have an en-suite facility they prefer to use a commode and one had been specially supplied for them. Since the last inspection many areas of the home had been redecorated, new carpeting laid, new beds and additional seating and hoists purchased as well as some new trolleys and wheelchairs. On the day of this visit the home was found to be very clean and tidy and the handyman was steam cleaning a number of the carpets. The home has a well equipped laundry where good attention was seen to being given to maintaining good infection control measures with supplies of gloves paper towels Care Homes for Older People Page 18 of 26 Evidence: and hand wash seen to be freely available. Infection control training is booked for all staff next month. The home had a Swine Flue policy and the procedure is on prominent display. The home benefits from having a large enclosed garden which has a sheltered patio area where comfortable garden furnishings and umbrellas are provided. On the day of our visit a BBQ lunch was being prepared and additional works were being carried out to the hanging baskets and flower tubs. A number of residents told us how much they enjoyed being able to sit in the garden and watch the birds and other wildlife. Care Homes for Older People Page 19 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service can be confident that they will be supported by appropriate numbers of skilled and fully trained staff who have been robustly recruited to protect them and to ensure the smooth running of the service. Evidence: The home benefits from excellent staff numbers and retention and gives very good priority to staff training. All of the existing staff team except one older experienced care worker hold NVQ qualifications at level 2. Since the last inspection two members of staff have completed NVQ at level 3 and three other staff have now commenced this level 3 training. One care worker is currently undertaking a professional cook qualification at level 2 and the homes manager who already has the RMA registered managers qualification at level 4 is studying for an NVQ in IT. The home is therefore always managed by qualified and experienced staff many of whom have worked at the home for many years. The home has sufficient numbers of permanent and bank staff so that it only very rarely if ever has to use agency staff and even then only one known agency and one of two known care workers who are familiar with and understand the routine of the home are used. The home has a robust recruitment procedure and recruitment records checks found that all the required checks had been made before a post was confirmed. New staff do not commence duties until a CRB check has been received all new staff then undertake an induction training programme Care Homes for Older People Page 20 of 26 Evidence: and work initially alongside an experienced staff member. All the staff spoken with said that they were very well supported by the homes manager. Supervision records evidenced that regular individual and group supervision is given this is planned ahead and properly recorded and an annual appraisal is undertaken. The homes training programme is published and is planned to meet the training needs of the staff as identified during their supervision meetings. Refresher courses for the core subjects such as health and safety, manual handling ,infection control and first aid were seen to be up to date. Since the last inspection all staff have completed further Safeguarding and Medication courses and several have attended training concerning the Mental Capacity Act. Care Homes for Older People Page 21 of 26 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. People who use this service benefit from the sound management of the home and the homes person centered ethos ensures that it is run in their best interests. Administration practices in the home protect service users and promote a safe environment. Evidence: The home is managed by a qualified and experienced manager who is assisted by a stable trained and experienced staff group many of whom have worked at the home for several years. Staff were observed to work very well together as a team and were without exception very positive about their work and in promoting the quality of service given at Shenleybury House. During their discussions with us during this visit they confirmed that they were always very well supported by the homes manager and that they each had a supervision contract. One said this is a happy place to work and I really look Care Homes for Older People Page 22 of 26 Evidence: forward to coming to work. Another told us that we can really put the needs of the residents first and all work together to ensure their very good care. The home has clear health and safety policies and staff spoken with had a good awareness of these. The home gives good priority to promoting the health safety and welfare of the residents and staff through the regular maintenance of safety checks, training and record keeping. Random checks are made by the Manager to ensure that standards are maintained. Spot checks made by us found that all these records were very well maintained. Checks made on the records relating to fire testing and the monitoring of water temperatures found these to be regularly completed along with the servicing and safety checks for the homes equipment. All records were seen to be kept securely. The home does not keep any of the residents monies. All the residents have locked facilities in their rooms for the secure keeping of valuables and money. Since the last inspection Shenleybury has further improved its programme of quality assurance monitoring based on regularly seeking the views of residents relatives professionals and other stakeholders in the home. The replies received are evaluated and are shared with the residents and relatives at their meetings so that lessons can be learned and further improvements made to the services offered at the home. Care Homes for Older People Page 23 of 26 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 24 of 26 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 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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