Inspection on 16/04/09 for The Sheiling

This is the latest available inspection report for this service, carried out on 16th April 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.

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Extracts from inspection reports are licensed from CQC, this page was updated on 10/07/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Sheiling The Sheiling 81-83 Colman Way Redhill Surrey RH1 2BB     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: Jo Griffiths     Date: 2 7 0 4 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 Adults (18-65 years) 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 Adults (18-65 years) Page 2 of 28 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 Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: The Sheiling The Sheiling 81-83 Colman Way Redhill Surrey RH1 2BB Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mitchells Care Homes Limited Type of registration: Number of places registered: care home 9 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: 1. The registered person may provide the following category/ies of service only: Care home only (PC) to service users of the following gender Either Whose primary care needs on admission to the home are within the following categories: Learning disability - (LD) 2. The maximum number of service users to be accommodated is 9. Date of last inspection Brief description of the care home The sheiling is a care home for up to 9 adults with a learning disability. The home provides care and support to people based on an individual assessment of their needs. The home is located in Redhill and has easy access to shops and other facilities. Everyone has a single bedroom and access to shared facilities including a lounge, Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 9 Brief description of the care home dining room, kitchen, laundry, bathrooms and a garden. More information about the service and a copy of the Statement of Purpose can be obtained from the Manager. The current fees for this service range from £850 to £1536 per week. Care Homes for Adults (18-65 years) Page 5 of 28 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The sheiling was registered as a Limited Company in November 2008, but continues to be run by the same Service Provider. This was the first key inspection of the service under the new registration. The inspection involved reviewing the Annual Quality Assurance Questionnaire (AQAA) that the manager sent to the Commission before the inspection. The inspector also looked at information that had been received about the service since its registration. Two visits were made to the home as the service users were not at home to speak with the inspector on the first visit. The inspection visits included reviewing documents and records, a tour of the home and speaking with service users and the manager. Surveys were also sent to five people using the service and these were completed and returned to the Commission. Care Homes for Adults (18-65 years) Page 6 of 28 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. 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 Adults (18-65 years) Page 7 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 28 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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 interested in moving to the home are provided with the information they need to make a decision about using the service. They have an assessment of their needs to ensure these can be met and have their needs regularly reviewed. The service demonstrates that it can meet the range of needs specified in the Statement of Purpose and is flexible in its approach to ensure that the diversity of service users needs is acknowledged and respected. Evidence: The Statement of Purpose was seen and this had been updated to reflect the new registration of the service. The Service User Guide is in easy-to-read format and has been issued to all service users to keep in their rooms. Assessments were completed for all service users when they moved into the home and these have been reviewed at least annually by the manager and keyworker. The assessments include peoples cultural needs and examples were given of how these are met including dietary needs, personal care requirements and forms of worship. Care Homes for Adults (18-65 years) Page 9 of 28 Evidence: Recently care managers have visited service users to carry out new community care assessments to ensure that they are receiving the most appropriate type of service for their needs. The manager demonstrated an excellent understanding of the need for the service to be flexible in approach to meet peoples diverse and changing needs. Care Homes for Adults (18-65 years) Page 10 of 28 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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 using the service have a person centred plan and are supported to make their own decisions in their lives. They are encouraged to have a say in the running of the service and give their feedback at regular intervals. Evidence: Each service user has a person centred plan that they have been involved in completing. Two of the plans were seen as part of the inspection and these showed that all areas of need in the persons life had been addressed. The manager described how the needs of the person when they are outside the home, for example at the day centre, are incorporated into the plan to ensure a holistic approach to the support they receive. There was evidence in the file that service users are supported to organise their own person centred planning meetings and set the agendas for this. Two service users spoken with confirmed this. The plans showed that people have been encouraged to make their own decisions in their lives for example deciding where and how they wish Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: to live, what activities they wish to do, whether they wish to find work and how they would like to spend their leisure time. Risk assessments have been included as part of the plans. These range from being able to manage their medication independently to going out alone for activities in the community. The manager and the keyworker have regularly reviewed the plans to ensure they continue to meet peoples needs. House meetings are held monthly for all the people living in the home. This is their opportunity to have a say about how the service is run, make suggestions, plan activities, write menus and raise any concerns. The manager produces the minutes in symbol format so that the service users can understand them, but currently none of the service users wish to have a copy. Service users are also involved in the running of the home through being part of the recruitment interviews for new staff. Care Homes for Adults (18-65 years) Page 12 of 28 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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 using the service are supported to lead the lifestyles that they choose and which suit their needs and there are regular opportunities for activities both within the home and the local community. Individuals rights to make and maintain friendships and relationships with their family are respected and supported. The people that live in the home are supported to meet their responsibilities and help with the running of the home, their rights to treat the home as their own are respected. There is a varied menu that offers plenty of choice and people using the service say they are happy with the meals. Evidence: The care plans for two people using the service were inspected and two further service Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: users were asked their views on the lifestyle they can lead in the service. The feedback was positive and confirmed that people are consulted about how they spend their time. The person centred plans also demonstrated this. Some people use a day centre for their activities during the week, some have part time jobs and some undertake activities with staff from the care home. Those that wish to seek employment are supportd by staff to contact the employability scheme who help people develop their skills and find suitable work. At the weekends and evenings people can choose how they spend their time. Two people said they enjoy listening to music and watching TV in their rooms, playing the karaoke machine, going to the cinema, going to rangers and going to social clubs. Many people also attend a place of worship of their choice each week. The manager explained how people are regularly consulted about how they spend their time to ensure they are still doing the things that interest them. One person is currently being supported to change their hours at their job to better suit them. The records show that people lead busy and interesting lives and that everyone is supported individually to plan their social lives. People spoken with in the home said they can invite friends for dinner if they wish to. They also said they get on well with the other people living in the home. Everyone has the opportunity to choose where they wish to go on holiday each year. Front door keys have been issued to those who want them. People are supported to take responsibility for their own home to a certain extent and this includes cooking, cleaning, laundry and washing the car. It is recommended that this be further expanded to encourage the service users to run the home as their own even further, for example by answering the phone and front door. It is also recommended that people be supported to do their own laundry individually and separately from others laundry in the home, rather than participating in doing laundry for everyone. This promotes independence and is more pleasant for service users. There is currently a four week menu agreed by the dietitian. People spoken with in the home said that they choose what goes on the menu and that it is changed a couple of times a year. The manager plans to change the way menus are written. The service users will be supported to plan the menu weekly and budget and buy the food required. This will help to increase their independence skills in order for them to progress on from the care home in the future if they wish to. A record is kept if people have anything different to the planned menu and Service Users spoken with said that they can have something else if they do not like what is offered. Fresh fruit, snacks and drinks are always available and everyone has free access to the kitchen, although Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: some require more staff support than others. It is planned that some staff will undertake training in nutrition. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their personal care needs met in a way that promotes their independence and their dignity. They are supported to identify their health needs and arrange appointments with healthcare professionals as needed. People are supported to take their medication safely and are given the correct level of support they need to do this. Evidence: The personal care needs of individuals are outlined in their person centred plan following an assessment of their needs. People are encouraged to be a self managing as possible in this areas and staff support is provided where identified as needed. Same gender personal care support is provided. The manager has sought advice about specific cultural needs regarding personal care and incorporated these into the plans. Everyone has access to a hairdresser of their choice, although most choose to use the one that visits the home, and people are supported to express themselves as they choose through their appearance and style of dress. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: People that use the service are registered with a GP surgery of their choice and can choose the GP they use within the surgery. Everyone has regular appointments with dentists and opticians and, where needed, audiology. Staff support service users to maintain any equipment they have, for example, hearing aid or spectacles. The medication that people are prescribed is stored securely in the home and is only administered by trained and competent staff. Records are kept and these showed that medicines are given as prescribed. One person has recently been supported to manage their own medication. A risk assessment and safeguards are in place to ensure they can do this safely. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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 using the service know how to make a complaint if they need to and feel that their views are listened to. They are safeguarded from harm and abuse by trained staff and robust safeguarding procedures. Evidence: The complaints procedure is in easy read picture format and has been issued to all service users and their relatives. The surveys received from people in the home confirmed that they all knew how to make a complaint if they needed to and that they felt staff listened to and acted upon any concerns they may have. Two service users spoken with during the inspection said they knew who to speak to if they had a complaint. This included talking to people at the day centre. There have been no complaints received by the home or by the Care Quality Commission. A letter of compliment to the service was seen. Before anyone starts work in the home they are required to have a Criminal Records Bureau (CRB) check and a number of pre-employment checks, including taking written references, are made. All staff have completed training in safeguarding adults and are booked for a refresher course where this is required. The manager has undertaken training with Surrey Council and has an excellent understanding of the reporting procedures for any allegations of harm or abuse. The manager has completed training on The Mental Capacity Act and Deprivation of Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: Liberty and booklets are available in the home for staff on this subject. Care Homes for Adults (18-65 years) Page 19 of 28 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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 using the service live in a clean, safe and comfortable home. They have access to sufficient shared space and their private space is respected. Their bedrooms are fully furnished and are appropriate to their needs. Evidence: The home is kept clean and decorated to a good standard. There is a large comfortable lounge and dining room and a spacious kitchen that is accessible to service users to prepare their meals and drinks. Everyone has a single bedroom and has access to bathroom facilities near their room. Two people showed the inspector their bedrooms and these were seen to be fully furnished and very personalised with their belongings. They confirmed that staff respect their privacy in their bedrooms and said they can invite people into their rooms as they wish. Service users said they are supported by staff to keep their rooms clean. The rear garden is safe and accessible for service users to use and the driveway to the front of the house has been recently repaved. The manager keeps a maintenance book for reporting any repairs that are required and makes a weekly check on this as part of the health and safety check. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: People spoken with in the home say they like their home and their rooms and feel safe and comfortable. Care Homes for Adults (18-65 years) Page 21 of 28 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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 that use the service are supported by sufficient numbers of trained, qualified and competent staff to meet their needs. They are safeguarded by the homes procedures for recruiting new staff. Staff are supported and supervised by the manager in their roles to ensure they continue to meet service users needs. They are provided with the training they need to carry out their roles. Evidence: Service users confirmed in the surveys sent to them that they are happy with the staff that support them. One person commented that The staff are very nice, helpful and caring. The two people spoken with during the inspection said that they liked the staff and felt they get the right amount of support from them. Staff seen working on duty during the inspection spoke to service users in a respectful and courteous manner. The recruitment files for two staff were checked and these both contained evidence that the required checks had been made prior to appointment. This included written references, an interview, employment history and a CRB. The Registered Provider has registered with the Home Office and training has been provided to the manager on how to check the validity and authenticity of identification documents. All staff have Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: been issued with a copy of the General Social Care Council (GSCC) code of conduct. The training record was seen for all staff and some certificates were checked as a sample. This showed that staff have completed all the core training they need and updates have been booked where needed. Some staff have also completed additional training specific to service users needs, for example, dementia. Most staff have completed the NVQ award and all staff complete an induction that meets the skills for care standards when they start work at the home. Completed inductions were seen on the two files checked. All staff have had a training needs analysis and a training plan is in place for the year 2009/2010. All staff have monthly supervision which also includes some direct observations of their work. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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 using the service benefit from a home that is managed effectively by a competent, approachable and experienced manager. The service is run in their best interests and they are regularly consulted on their views. The health and welfare of service users and staff are promoted and protected. Evidence: The manager of the home is experienced in managing the service and has recently completed the Registered Managers Award. She plans to undertake further training including the NVQ level 4 in care. The manager demonstrates a commitment to keeping up to date with current good practice in the field of learning disabilities through regular training sessions and conferences. She has access to the Internet and uses this to keep up to date with any changes in legislation. The manager has an open approach and works directly with the service users to ensure she has a full understanding of their needs. She has built an excellent relationship with service users, staff and relatives and demonstrates she is able to Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: liaise well with other professionals. From the surveys sent to service users and from conversations with people during the inspection it is clear that people feel they can talk to the manager about any concerns they may have. Throughout the inspection, and within the AQAA, the manager described plans for improvement for the service and acknowledges that the service needs to be continually reviewed. There are monthly quality assurance audits of the service by another manager in the organisation and the manager of the Sheiling regularly audits and checks medication, finances, person centred plans and health and safety. Each year surveys are sent to people living in the home and their relatives. The results of these are collated and these were seen. The feedback about the service is positive and reflects the information provided within the AQAA. It is recommended that names are not added to the surveys to allow the person to contribute anonymously if they wish. There are monthly meetings for service users to have say in how the home is run and the manager speaks with people daily to ensure they are happy with the service. Care Homes for Adults (18-65 years) Page 25 of 28 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 Adults (18-65 years) Page 26 of 28 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 1 16 It is recommended that service users be further supported to take responsibility for their own home, for example, by answering the telephone and front door. It is recommended that service users be supported to do their own laundry separately from that of other people in the home. It is recommended that service users have the option to complete quality assurance surveys anonymously. 2 16 3 39 Care Homes for Adults (18-65 years) Page 27 of 28 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. 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