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Inspection on 18/02/09 for Silver Springs

Also see our care home review for Silver Springs for more information

This is the latest available inspection report for this service, carried out on 18th February 2009.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Not yet rated. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

We observed good interaction between care staff and residents during the visit and residents appeared happy and busy. Residents had a craft session provided by a member of staff who is employed to provide activities and outings and we spoke briefly with one resident at this time although this person had limited communication abilities. We spoke with several members of care staff at the home and these care workers said that they were aware of the Complaints and Whistle Blowing policies at the home. The care staff told us that the care provided was person centred and that residents were encouraged to make choices about how they spend their days. The residents we spoke with were unable to give clear answers to our questions but we observed that interaction between residents and care staff appeared good. We checked the recruitment record of a care worker who had recently started work at the home. We saw evidence that appropriate employment checks were in place before the care worker started work.

What the care home could do better:

We identified several areas where improvements are needed in the home and the manager confirmed that action is being or will be taken to ensure changes are made. During the inspection the manager informed us that she had reviewed the needs of one resident and had informed the placing authority that the home could no longer meet this resident`s needs. The manager said a planned move would be taking place for this resident. As a result of issues raised with the manager by reviewing officers maintenance work was underway at the home on the day of the inspection. Appropriate adaptations had been made to a lock on the front door. A double locking device had been removed and the door was now alarmed. This means that able residents are now able to open the door when they wish but the alarm will alert staff that the door is open so that care staff can be sure all residents remain safe if they wish to go out. A reviewing officer had also found that the ground floor bathroom was very cold on the day of their visit. As a result of this we saw an additional radiator being installed on the day of our visit. We saw a copy of the staff duty roster for the week during the inspection. This showed that, from Monday to Friday there were four care staff on duty in the morning, three in the afternoon and two at night. The roster showed fewer staff were on duty at the weekend but the Proprietor said that the roster was not finished and that more staff would be on duty and their names would be added. The manager`s name was not on the roster but the Proprietor said that the manager was "supernumery" to the staffing numbers. The manager was not on duty when the inspection started but arrived later in the morning. The Proprietor was reminded that the weekly staff roster must accurately detail the names of all staff who work at the home and must be kept as a legal document. We were provided with the staff training matrix during the visit. This showed that staff training courses have been booked throughout the year and these covered all appropriate subjects. However the details also showed that most of the staff were currently not up to date with essential training and this could mean that care staff were not adequately trained at present to meet all residents` needs. Regular training must be provided for all care staff and the manager confirmed that this would continue to be done. During the Serious Concerns meeting, officers who had recently visited the home felt that the home`s Policies and Procedures were not up to date and that the system for handling residents` personal allowances was not appropriate. It was aslo noted during the meeting that the manager had not sent information to the Commission and to the relevant Local Authorities about issues and accidents which had taken place at the home. This action is required under the Care Homes Regulations and by the terms of the Local Authority contracts. During the inspection the manager demonstrated a recently introduced system which will ensure that all accidents, incidents and appropriate issues are reported to the Commission and to the Local Authority. Each resident`s care plan now has blank notification forms included in the file with instructions to staff how to complete and where to send the forms. The manager said that the procedure has been explained to all staff members and one care worker confirmed they were aware of the procedure. The manager is changing the system for dealing with residents` finances. All residents have accounts with a building society and previously money was drawn out from these accounts and kept in a joint fund in the home. In the new system the residents will collect their money from the building society and will keep their own personal allowances in the safe provided in each bedroom. All residents have their own cash book and we tracked the money of one resident during the inspection. The cash counted tallied with the records shown in the individual`s cash book and building society book. The manager is currently acting as a trustee for three residents but confirmed that she will be ending this responsibility and has asked the relevant social workers to make alternative arrangements for the residents concerned. We checked the system for administering medication. The system was basically sound but the manager must provide a medication fridge for the home and purchase a record book for controlled drugs, in line with current legislation. The manager confirmed these items would be provided as soon as possible. We checked the home`s written Medication Policy and found this was inadequate and out of date. The manager said that this and other written policies in the home were being reviewed and updated at this time. During the visit we saw one bedroom door held open with a door wedge. We reminded the Proprietor that this device would compromise the fire safety system and could put residents at risk of harm. The Proprietor removed the wedge and confirmed th

Inspecting for better lives Random inspection report Care homes for adults (18-65 years) Name: Address: Silver Springs 12 Rosslyn Road Watford Hertfordshire WD18 0JY new service which has yet to be given a quality rating 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 assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. 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: Patricia House Date: 1 8 0 2 2 0 0 9 Information about the care home Name of care home: Address: Silver Springs 12 Rosslyn Road Watford Hertfordshire WD18 0JY 01923227852 01923227852 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) : Mrs Devi Sedani,Mr K.P. Sedani care home 10 Number of places (if applicable): Under 65 Over 65 0 0 learning disability physical disability Conditions of registration: 10 3 Residents with physical disability (when associated with a learning disability) shall not exceed 3 at any one time within a total of 10 residents. This home is registered for 10 people with a learning disability or physical disability (when associated with a learning disability). Date of last inspection Brief description of the care home Silver Springs is a care home providing personal care and accommodation for ten people who have a learning disability. Three of these may also have a physical disability. It is privately owned, and one of the proprietors is also the manager. The home is situated close to local shops and the main town centre of Watford is within walking distance. It is a two storey terraced house, providing ten single bedrooms for the residents. None of the bedrooms have en-suite facilities. The house provides a Care Homes for Adults (18-65 years) Page 2 of 9 Brief description of the care home domestic environment and it is indistinguishable from the neighbouring houses. The Statement of Purpose, Service User Guide and previous CSCI inspection reports are available at the mangers office at Silver Springs (a copy of the Service Users Guide will be provided to prospective service users by the home) CSCI inspection reports are also available on the CSCI web site. Information on the fees charged was not available on this occasion. Care Homes for Adults (18-65 years) Page 3 of 9 What we found: The last key inspection of the home took place on 3rd January 2008. This inspection took place as a result of some concerns which had been raised about the home and which resulted in a Serious Concerns Meeting being held under Hertfordshire County Council Adult Care Services joint agency safeguarding vulnerable adults procedures. Some of the concerns raised at this meeting are identified here along with our findings about the issues. We also assessed some other areas during the visit and findings are included in this report. The inspection took place over part of one day with one regulation inspector carrying out the work of the Commission. For the purposes of this report the Commission will be referred to as we. The registered manager was not on duty when we arrived at the home but the joint Proprietor was there and showed us around the building where maintenance work was in progress. The manager arrived in the home during the inspection. What the care home does well: What they could do better: We identified several areas where improvements are needed in the home and the manager confirmed that action is being or will be taken to ensure changes are made. During the inspection the manager informed us that she had reviewed the needs of one resident and had informed the placing authority that the home could no longer meet this residents needs. The manager said a planned move would be taking place for this resident. As a result of issues raised with the manager by reviewing officers maintenance work was underway at the home on the day of the inspection. Appropriate adaptations had been made to a lock on the front door. A double locking device had been removed and Care Homes for Adults (18-65 years) Page 4 of 9 the door was now alarmed. This means that able residents are now able to open the door when they wish but the alarm will alert staff that the door is open so that care staff can be sure all residents remain safe if they wish to go out. A reviewing officer had also found that the ground floor bathroom was very cold on the day of their visit. As a result of this we saw an additional radiator being installed on the day of our visit. We saw a copy of the staff duty roster for the week during the inspection. This showed that, from Monday to Friday there were four care staff on duty in the morning, three in the afternoon and two at night. The roster showed fewer staff were on duty at the weekend but the Proprietor said that the roster was not finished and that more staff would be on duty and their names would be added. The managers name was not on the roster but the Proprietor said that the manager was supernumery to the staffing numbers. The manager was not on duty when the inspection started but arrived later in the morning. The Proprietor was reminded that the weekly staff roster must accurately detail the names of all staff who work at the home and must be kept as a legal document. We were provided with the staff training matrix during the visit. This showed that staff training courses have been booked throughout the year and these covered all appropriate subjects. However the details also showed that most of the staff were currently not up to date with essential training and this could mean that care staff were not adequately trained at present to meet all residents needs. Regular training must be provided for all care staff and the manager confirmed that this would continue to be done. During the Serious Concerns meeting, officers who had recently visited the home felt that the homes Policies and Procedures were not up to date and that the system for handling residents personal allowances was not appropriate. It was aslo noted during the meeting that the manager had not sent information to the Commission and to the relevant Local Authorities about issues and accidents which had taken place at the home. This action is required under the Care Homes Regulations and by the terms of the Local Authority contracts. During the inspection the manager demonstrated a recently introduced system which will ensure that all accidents, incidents and appropriate issues are reported to the Commission and to the Local Authority. Each residents care plan now has blank notification forms included in the file with instructions to staff how to complete and where to send the forms. The manager said that the procedure has been explained to all staff members and one care worker confirmed they were aware of the procedure. The manager is changing the system for dealing with residents finances. All residents have accounts with a building society and previously money was drawn out from these accounts and kept in a joint fund in the home. In the new system the residents will collect their money from the building society and will keep their own personal allowances in the safe provided in each bedroom. All residents have their own cash book and we tracked the money of one resident during the inspection. The cash counted tallied with the records shown in the individuals cash book and building society book. The manager is currently acting as a trustee for three residents but confirmed that she will be ending this responsibility and has asked the relevant social workers to make alternative arrangements for the residents concerned. We checked the system for administering medication. The system was basically sound Care Homes for Adults (18-65 years) Page 5 of 9 but the manager must provide a medication fridge for the home and purchase a record book for controlled drugs, in line with current legislation. The manager confirmed these items would be provided as soon as possible. We checked the homes written Medication Policy and found this was inadequate and out of date. The manager said that this and other written policies in the home were being reviewed and updated at this time. During the visit we saw one bedroom door held open with a door wedge. We reminded the Proprietor that this device would compromise the fire safety system and could put residents at risk of harm. The Proprietor removed the wedge and confirmed that fire doors would not be held open in future. We also saw that another residents room had a gate fitted in the door frame. The Proprietor said this was to maintain the privacy of the resident concerned. We told the manager that this equipment was a restraint and must be reviewed with the appropriate agencies and risk assessed in line with current guidelines on restraint and with fire safety procedures. In the bedrooms we visited we also noted that there were no call alarms in place. We told the Proprietor that these are considered to be safety devices to protect residents and that if they are not provided details of the reasons for this omission must be evidenced in individual care plans. The Proprietor said that the installation of call alarms would be reviewed. 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 Adults (18-65 years) 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 Adults (18-65 years) 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 Care Homes for Adults (18-65 years) Page 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI 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 Adults (18-65 years) 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: 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 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 Adults (18-65 years) Page 9 of 9 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!