CARE HOME ADULTS 18-65
Buckwood View 6 Buckwood View off Gleadless Road Sheffield South Yorkshire S14 1LX Lead Inspector
Jayne Barnett-Middleton. Unannounced Inspection 14th December 2005 08:30 Buckwood View DS0000041058.V261374.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Buckwood View DS0000041058.V261374.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Buckwood View DS0000041058.V261374.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Buckwood View Address 6 Buckwood View off Gleadless Road Sheffield South Yorkshire S14 1LX 0114 253 0400 0114 253 1220 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Northern Counties Housing Association Ltd Mrs Michelle Taylor Care Home 18 Category(ies) of Learning disability (18) registration, with number of places Buckwood View DS0000041058.V261374.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Minimum staffing levels must be maintained as stated in the documents entitled `Buckwood View Approved Staffing Levels` faxed to the NCSC on 8 April 2003. The five named wheelchair users can be admitted to the home at the time of first registration. No other persons whose main source of independent mobility is a wheelchair may be admitted. Nine specific service users over the age of 65, named on variation dated 11th August 2004, may reside at the home. 27th July 2005 2. 3. Date of last inspection Brief Description of the Service: Buckwood View Nursing home was opened in April 2003. It was purpose built to meet the National Minimum Standards for care homes. Eighteen people with learning disabilities live at the service which is based in the community. Northern Counties Housing Association owns the care home. The care staff who work at the home are employed by the Sheffield Care Trust. There are six houses at the service, an office building and a day service base, which are all based on a small cul-desac. All of the houses have gardens to the rear. The home is based near to community facilities, shops and bus stops. Buckwood View DS0000041058.V261374.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. Jayne Barnett - Middleton carried out this unannounced inspection from 08.30 to 14:10 pm. Michelle Taylor, registered manager, from Sheffield Care Trust was present during the inspection. Opportunity was taken to make a tour of the premises, inspect a sample of records and policies and talk to staff and residents. The inspector had the opportunity to speak to all of the staff on duty and three visitors. It was not possible to formally interview any of the residents, due to their high support needs but the inspector spoke to several residents informally. What the service does well:
Residents had person centred plans, which identified in detail how personal support should be offered to each individual. Resident’s files contained detailed risk assessments relating to all aspects of residents lives both inside and outside the home. Residents had regular opportunities to access appropriate activities. Regular activities were available within the home including, wheelchair aerobics and art therapy and a luncheon club, Agewell luncheon group, which is open to other people with a learning disability in the community. There were detailed records of activities that had taken place, which included shopping trips, visits to the peak district and parties. Several holidays had taken place including a trip to the new forest and Wales. Three residents with high support needs had recently taken a holiday to Gran Canaria. The staff team is very stable and most of the staff team have worked with the service users for many years. All the staff spoken to were professional, relaxed, friendly and were able to demonstrate a very good knowledge of residents individual needs. Residents were observed to be receiving care in a manner that respected their privacy and dignity. Residents were well dressed and had received a good standard of personal care. Staff had received training appropriate to their role to ensure that they were conversant with changing legislation and safe working practices. Staff confirmed that a good range of training was available. The staff team were responsible for housekeeping duties. It was evident that this arrangement worked very well. All houses were very clean and odour free which provided a hygienic and homely environment for residents. Relatives spoke highly of the service provided. They described the staff team as “wonderful” and “excellent” and commented that the home was “always very clean”.
Buckwood View DS0000041058.V261374.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Buckwood View DS0000041058.V261374.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Buckwood View DS0000041058.V261374.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 None of the current residents had needs assessments as they had moved from another Sheffield Care Trust nursing home straight in to this home. EVIDENCE: Not applicable. Buckwood View DS0000041058.V261374.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9. Residents had individual care plans, which contained detailed information about their care and support needs. Risk assessments, which supported residents to lead full lifestyles, minimised risks for the individual had been devised and reviewed regularly. EVIDENCE: Care plans checked set out in detail the action that was required by staff to ensure that all aspects of resident’s personal, social support and healthcare needs were met. Records checked confirmed that care plans were reviewed on a frequent basis to reflect the resident’s current needs. Care plans had been updated to ensure that they met the required standard. Medication review dates were recorded and weight monitoring records were being maintained. One relative said that they would like to be involved in the review of their daughters care plan. Buckwood View DS0000041058.V261374.R01.S.doc Version 5.0 Page 10 Resident’s files contained detailed risk assessments relating to all aspects of residents lives both inside and outside the home. They clearly identified the individual risks that were presented to residents on a daily basis and the action required to reduce the risk, which enabled residents to live an independent lifestyle. Buckwood View DS0000041058.V261374.R01.S.doc Version 5.0 Page 11 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16 and 17. Residents were encouraged to maintain and develop social and independent living skills. Opportunities were provided for service users to engage in activities within the home and maintain links within the local community. Residents were encouraged to eat a healthy and varied diet. EVIDENCE: Residents had regular opportunities to access appropriate activities. Regular activities were available within the home including, wheelchair aerobics and art therapy and a luncheon club, Agewell luncheon group, which is open to other people with a learning disability in the community. On the day some residents were visiting local day centres. One resident with high support needs was being supported to visit the town centre. Buckwood View DS0000041058.V261374.R01.S.doc Version 5.0 Page 12 Since the last inspection the frequency of activities had been reviewed. The staff and manager reported that extra staff were designated to provide more one to one support to residents with high support needs. There were detailed records of activities that had taken place, which included shopping trips, visits to the peak district and parties. The manager and staff spoke of the many holidays that had taken place including a trip to the new forest and Wales. Three residents with high support needs had recently taken a holiday to Gran Canaria. The manager and staff were proud of this achievement and said that the residents had thoroughly enjoyed their holiday. Relatives confirmed that they could visit the home at any reasonable time and were always made to feel welcome. Residents were offered and encouraged to eat a healthy diet. Menus varied dependent on the resident’s likes and dislikes. Details of the resident’s preferences and special needs were recorded in the care plans checked and staff made a record of the menus taken on a daily basis. The staff had a good knowledge of individual needs and were able to describe resident’s individual preferences. Buckwood View DS0000041058.V261374.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20. Residents received personal support, which promoted their privacy, dignity and independence. Resident’s physical and emotional needs were met. Daily records were detailed to ensure that the resident’s healthcare needs could be monitored. A policy and procedure to ensure that staff adhered to the safe administration of medication was in place. EVIDENCE: The staff had a good awareness of service users individual physical and emotional needs and spoke positively about the progress that some residents had achieved. Residents had person centred plans, which identified in detail how personal support should be offered to each individual. Residents received good support from healthcare professionals who visited them. There were records to evidence that residents were receiving regular visits from healthcare professionals dependent on their needs. Buckwood View DS0000041058.V261374.R01.S.doc Version 5.0 Page 14 Daily records were maintained of the resident’s physical and emotional health and the care that had been provided. Records of the resident’s physical needs, regarding health care appointments were up to date ensuring that they were receiving appropriate health care at the frequency required. There was a medication policy and procedure to ensure that staff adhered to safe practices. Medication checked was stored and had been administered appropriately. Staff had received medication training; all promoting that medication was appropriately administered to residents. Buckwood View DS0000041058.V261374.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. The home complaints procedure was clear and accessible. Complaints made by residents and their relatives were listened to and action was taken to deal with complaints promptly. There was an adult protection procedure, which promoted the protection of residents. EVIDENCE: The complaints procedure ensured that residents and their relatives were aware of how to make a complaint and who would deal with them. The manager said that none of the residents had made complaints at the home over the last six months. Staff spoken to was confident that any complaints/concerns would be dealt with appropriately. Relatives said that they had no complaints commenting that the residents were “well cared for”. There was an adult protection policy and procedure that promoted the protection of service users from harm or abuse. Since the last inspection a senior member of staff had completed training to enable her to facilitate Adult Protection training. The staff member was able to demonstrate an excellent awareness of the homes adult protection procedures. All staff had received instruction on the homes adult protection procedures. Further training was scheduled for January 06 to enable staff to identify and report any allegations or incidents of abuse to residents. Buckwood View DS0000041058.V261374.R01.S.doc Version 5.0 Page 16 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26 and 30. The home was clean, comfortable and on the whole well maintained. Residents were provided with an environment that met their individual needs and lifestyles EVIDENCE: The flats were generally well maintained, clean and furnished in a homely manner. The patios and garden areas were very well maintained, safe and accessible to residents. The staff commented that the garden was popular during the summer months and described events that had taken place, which the residents had enjoyed. Buckwood View DS0000041058.V261374.R01.S.doc Version 5.0 Page 17 Resident’s bedrooms were comfortable, individually furnished and personalised to meet their needs. It was evident that residents had been encouraged to personalise their bedrooms with photographs and ornaments, which encouraged residents to retain their own identity. All of the resident’s rooms have en-suite showers. At the last inspection the staff said that they experienced problems with the bathroom floors flooding and becoming slippy, which could pose a risk to residents and staff from falling. The manager confirmed that action had been taken to address this issue. Individual risk assessments had been undertaken and appropriate equipment had been provided to minimise the risk of accidents to staff and residents. The fire doors at the entrance to house 11 were not enabling easy access to wheelchair users. It was very awkward to open the heavy doors and push the residents in wheelchairs through at the same time. The manager confirmed that funding for this work to be undertaken had been agreed and that this work would be completed within the near future. The entrance carpets in House 7 and 15 were in need of replacement as they were stained and worn. New carpets had been ordered and it was anticipated that they would be fitted within the near future. The staff team were responsible for housekeeping duties. It was evident that this arrangement worked very well. All houses were very clean and odour free which provided a hygienic and homely environment for residents. Buckwood View DS0000041058.V261374.R01.S.doc Version 5.0 Page 18 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35 and 36. A caring and committed staff team supported residents. Staff received training and support appropriate to their role. The home operated a recruitment policy that promoted the protection of service users. Staff files required some amendments to ensure that they included the required information. EVIDENCE: The staff team is very stable and most of the staff team have worked with the service users for many years, they therefore know the residents very well and are able to provide a consistent service to them. It was evident that the staff had formed positive and appropriate relationships with residents. All the staff spoken to were professional, relaxed, friendly and were able to demonstrate a very good knowledge of residents individual needs. Relatives spoke positively about the staff team. They described the care that their relatives received as “wonderful” and “excellent”. Buckwood View DS0000041058.V261374.R01.S.doc Version 5.0 Page 19 Staff spoken to confirmed that they had received training appropriate to their role to ensure that they were conversant with changing legislation and safe working practices. The manager confirmed that new staff had completed the Learning Disability Award Framework, (LDAF) award, to give them a recognised induction into supporting the residents who live in the home. It was anticipated that existing staff would commence the training within the near future. A good induction programme was in place. One staff member who had recently been employed at the home confirmed that they had received the appropriate induction and support to carry out their role in a safe manner. A recruitment policy and procedure was in place. Two files checked contained a range of information including a declaration of health and qualifications/training. The files did not contain a full employment history of the employee or two references. All staff employed had undertaken a Criminal Records Bureau Check at the enhanced level to promote the protection of service users. The staff confirmed and records demonstrated that they were receiving regular supervision to enable them to discuss their development and to identify any training requirements. Buckwood View DS0000041058.V261374.R01.S.doc Version 5.0 Page 20 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42. The staff said that they were well supported by the management team. Forums were in place, which enabled residents and staff to contribute to the day-to-day running of the home. The health, safety and welfare of service users was promoted and protected. EVIDENCE: The registered manager had many years experience within the caring profession which, enabled her to contribute to the care of service users and communicate a clear sense of leadership to staff. The manager has completed the NVQ 4 management award to develop her management skills. The staff and relatives spoken to felt supported by the senior team and were confident in the senior teams abilities to manage the home. Buckwood View DS0000041058.V261374.R01.S.doc Version 5.0 Page 21 Staff meetings were held on a regular basis, which provided them with the opportunity to contribute to the day to day running of the service. Staff spoken to said that the meetings were useful and said that it provided a good opportunity to discuss issues and to discuss the service. The manager meets with the resident’s relatives on a regular basis, this group is called the, Friends of Buckwood View. The manager commented that the meetings were useful, enabling relatives to contribute to the development of the home. The staff had received regular training to promote the health, safety and welfare of service users and their colleagues. Buckwood View DS0000041058.V261374.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 X 3 X Standard No 24 25 26 27 28 29 30
STAFFING Score 2 3 3 X X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 3 2 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Buckwood View Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 3 X DS0000041058.V261374.R01.S.doc Version 5.0 Page 23 Are there any outstanding requirements from the last inspection? Yes. STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard YA6 YA24 Regulation 15 23 Requirement Care plans must be reviewed involving relatives, with the agreement of the service user. The home must be kept well maintainerd at all times. Maintenance issues identified in this report must be addressed. Staffs’ personal files must contain a record of the employee’s full employment history. Any gaps in employment must be accounted for and recorded. Staff’s personal files must contain a copy of two written references. Timescale for action 01/03/06 28/02/06 3 YA34 19 01/03/05 4 YA34 19 01/03/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. . . Refer to Standard None. Good Practice Recommendations Buckwood View DS0000041058.V261374.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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