Inspection on 09/10/07 for Housteads

This inspection was carried out on 9th October 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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.

Other inspections for this house

Housteads 28/08/06

Housteads 26/01/06

Housteads 01/09/05

Housteads 24/09/04

Housteads 06/04/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Housteads 1 Richmond Park Grove Sheffield South Yorkshire S13 8HX Lead Inspector Ms Stephanie Kenning Key Unannounced Inspection 9th October 2007 09:30 X10015.doc Version 1.40 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 Housteads DS0000002975.V347332.R01.S.doc Version 5.2 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 Older People. 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. Housteads DS0000002975.V347332.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Housteads Address 1 Richmond Park Grove Sheffield South Yorkshire S13 8HX 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) 0114 269 2469 0114 254 0903 martha.buchanan@sheffcare.co.uk www.sheffcare.co.uk Sheffcare Limited Ms Martha Buchanan Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Housteads DS0000002975.V347332.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th August 2006 Brief Description of the Service: Housteads is a purpose built 40-bed home for older people. It is in a residential area of Sheffield with good access to public services and amenities (e.g. bus services, shops, libraries etc). It is a bungalow type building. All the rooms are single rooms and it has a suitable number of lounges and dining rooms. The gardens are landscaped and it has a large car park. Copies of the last Commission For Social care Inspection reports were kept in the entrance for service users and their families to read. The weekly fees range from: £318 to £357 on 9th October 2007. The home charges extra for chiropody, toiletries, clothing, telephone, holidays and hairdressing. Housteads DS0000002975.V347332.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Since the previous inspection of 26th August 2006 a record has been kept of notified incidents and events at the home. Prior to the recent unannounced visit of October 9th 2007 information provided in The Annual Quality Assurance Assessment, completed by the manager, 5 service user surveys and one relative survey were assessed along with other information known about the home. The site visit from 9.30 to 4.45pm on October 9th, also contributed to this report. During the visit the inspector spoke to fourteen service users, four relatives, the district nurse, 2 GPs, a visiting local councillor, five staff and the manager, and would like to thank all for their openness, and contribution to the findings. The inspector was pleased to note that all people spoke positively of the ongoing support provided by the staff. Observations confirmed that people using the service were extremely comfortable and at ease in the company of the manager and staff whom they said were approachable, supportive and sensitive to their needs and feelings. The relatives described the service as ‘excellent’. A number of records were examined which included, medication records, three care plans of people currently at the home, menus and staff rotas. Records relating to staff recruitment, finances, staff training and the homes quality assurance systems were also checked. Several areas of the building were also inspected. Feedback on the findings was given to the manager before the inspector left the home. Two complaints had been dealt with in the past 12 months, one about a safety issue, and another had various issues including staffing, both records show that they were responded to quickly with satisfactory outcomes. What the service does well: What has improved since the last inspection? Housteads DS0000002975.V347332.R01.S.doc Version 5.2 Page 6 Those living at the home were pleased with the improvements to the décor and furnishings, and the kitchenettes provided on each corridor. They were also pleased with the new windows and doors that can be opened more easily. The range of activities has been increased as a result of direct input from people living in the home at meetings and in surveys. The management have addressed the other requirements made previously regarding checks to gaps in the employment histories of staff and by training more than 50 of staff in NVQ 2 or above. Although there have been a lot of staff changes since the last visit, the team has settled and were clear about their roles. 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. The summary of this inspection report can be made available in other formats on request. Housteads DS0000002975.V347332.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Housteads DS0000002975.V347332.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): People who use the service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. We looked at outcomes for standard 3. People do not move in to the home until a full needs assessment has been undertaken and the home can confirm they can meet the needs of that individual. EVIDENCE: All people moving in to the home have their needs assessed and they have been assured their needs could be met prior to admission. Detailed full needs assessments were completed for the people whose files were read. These had been completed by the referring social worker, or the Registered Manager for those people self- funding. Relatives confirmed that this process happened prior to admission and that their relative had opportunities to visit the home prior to making a decision about moving there. One relative said that although their mother had not wanted to move in to a home, they were very settled and happy there, and they had a lot of their belongings around them helping it feel like home. Staff members sometimes visit prospective residents in their own Housteads DS0000002975.V347332.R01.S.doc Version 5.2 Page 9 homes before admission to get to know them and tell them about the home. Someone was moving into the home on the day of the visit and we observed the time and attention given to that person and their relatives, giving reassurance at that difficult time. People are usually placed at the home for a 4 week trial period before having to make a decision to stay or not. One relative said that this was really helpful because it eased the pressure at a very difficult time. Housteads DS0000002975.V347332.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): People who use the service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. We looked at outcomes for standards 7, 8, 9 and 10. People’s individual personal and health care needs are met, staff support them in this, and respect their privacy. Medication systems follow clear guidelines that promote the safety of residents, and allow some people to be independent. EVIDENCE: Of the 32 people living at the home at the time of the visit most needed some degree of assistance with personal and health needs and 18 were classed as being disabled, and requiring a lot of support in their daily living. All of the people living at the home were classed as white British and their first language was English, which was not felt to represent the local community. There were only 6 men living at the home. There are 21 staff at the home, of whom 5 have an ethnic origin other than white British and 4 are male. All people living at the home have individual care plans that include physical, social, healthcare, religious and cultural needs. The files detailed what these Housteads DS0000002975.V347332.R01.S.doc Version 5.2 Page 11 needs were and the actions staff needed to take to help meet these needs. They linked to assessments, that were regularly updated, usually monthly, and then a review of the care plans so that each person gets the right care. Recent changes to health, and therefore needs and care required, were recorded, showing that they were up to date. People using the service and their relatives felt involved in this process and were able to specify individual preferences, such as they liked to spend time in their room, which was respected by staff. Relatives were pleased that residents always looked ‘well turned out’, and that staff treated them with kindness and respect. Staff members communicated well with the people at the home, including those people with communication difficulties, demonstrating that they were experienced and familiar with individual needs. Within the care plans were details of healthcare issues and the treatment required, including from visiting nurses, GPs, dentists, opticians, and chiropodists, showing the importance placed on accessing healthcare. During the visit 3 GPs, a dentist and a nurse visited the home and saw people for treatments in the privacy of their rooms. They felt that they had developed good working relationships with the home, and that their regular visits were valued, helping people to address problems quickly. The medication administration uses a monitored dose system from trolleys in the different units, helping to reduce the risk of mistakes. Staff members that administer medications are trained and assessed prior to them being able to do this, to improve the safety for residents. The medication records were completed correctly, and staff followed safe procedures during the visit. A recent change of giving medication after meals was being trialled to find out if meal times were more relaxed, and improved food intake, and had been a success so far. Those people requiring medication at specific times still had that medication as required, so that their best interests were met. 3 people partly manage their own medication with risk assessments and lockable facilities to improve safety. Housteads DS0000002975.V347332.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): People who use the service experience excellent outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. We looked at outcomes for standards 12, 13, 14 and 15. People living in the home have opportunities to take part in a wide variety of social events if they wish, have good links with the community and relatives, and are very positive about the meals provided. EVIDENCE: People living at the home talked about the different activities they chose to do, including watching television, bingo, going on outings to the coast or country, and events at the home. They felt able to choose which activities to join in with and some people felt able to spend time on their own or watching others participate, without pressure to join in. People living in the home can attend meetings where they can make suggestions for group activities and outings and other aspects of living at the home, which they felt was valuable as their views were listened to and acted upon. Relatives visiting the home said that they were invited to events and to go on outings, which made them feel welcome and involved, helping to support their relative. One family were very involved in their relatives care, including bathing, and doing the laundry, and others spoke about how the home kept them informed about the health and progress of their relative. The local Anglican Church holds a religious service at Housteads DS0000002975.V347332.R01.S.doc Version 5.2 Page 13 the home every month, and local councillors (elected members), hold regular surgeries at the home, showing good links with the local community. During the visit a number of people were taken to the local hairdressing salon as the visiting hairdresser was unavailable, and this was said to be an enjoyable outing. People living at the home were generally very happy about the meals, saying that they could choose from a menu and alternatives were available if they didn’t like what was offered. Most people felt that the quality and quantity of food was good, that it was hot and appetising. Meals were served in the dining areas of the 3 different units of the home and were observed to be relaxed, with sufficient staff assisting sensitively, making it a pleasant experience. Housteads DS0000002975.V347332.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): People who use the service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. We looked at outcomes for standards 16 and 18. People living at the home felt able to make their views heard and were confident that concerns would be listened to and acted upon. EVIDENCE: The home has established policies and procedures that relate to complaints and safeguarding of people who use the service, and these were familiar to staff, who were able to promote the rights of individuals. People living in the home felt able to talk to staff, including managers, when they had a concern and felt that they were listened to. Two complaints had been dealt with in the past 12 months, one about a safety issue, and another various issues including staffing, both records show that they were responded to quickly with satisfactory outcomes. There was a lot of praise for staff by people living at the home and their relatives, and also for the way the home was welcoming. Housteads DS0000002975.V347332.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): People who use the service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. We looked at outcomes for standards 19 and 26. People living at Housteads found it a comfortable, clean, warm and homely place to live, despite some minor problems with storage, décor and cleaning of difficult to access areas. EVIDENCE: People living at the home said that they found the home comfortable, clean and pleasant. They had noticed improvements to the décor and facilities that they were pleased with, and said that problems were put right quickly making it a safe place to live. The windows and some doors have been replaced, improving the ability to open and close these for the people living in the home. The kitchenette areas on the units had been refitted with new dishwashers and fridges providing good facilities accessible to those people able to use them. Bedrooms contained many personal items, which people said helped them to feel at home. Housteads DS0000002975.V347332.R01.S.doc Version 5.2 Page 16 There were some small areas of damage to décor in bathrooms and toilets that need to be addressed to improve the appearance, though the bathroom fixtures, such as baths, were clean and in good working order. A good range of bathing and lifting aids were available to assist people with disabilities. Some of the radiator covers were loose and debris had fallen behind some of them, and this was difficult to access. These were due to be removed for cleaning by the maintenance section, as the cleaners are unable to remove them. Bathrooms contained a number of items that were being stored there, such as a pressure relief mattress, hoists, commodes, dirty linen bins, and these make the bathrooms cluttered and difficult to use. An award of excellence has been awarded by the Department of environmental health for the levels of cleanliness at this home. Housteads DS0000002975.V347332.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): People who use the service experience excellent outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. We looked at outcomes for standards 27, 28, 29 and 30. People living at the home found the staff to be helpful, kind and well trained. EVIDENCE: During the visit we checked the staff rotas, observed staff working and talked to people living at the home, relatives and staff about the quantity and quality of the staff. People living in the home were very positive about the staff caring for them, saying things like ‘they’re wonderful’, and ‘they work really hard and will always help when I need them’. Relatives also said many positive things about the staff, for example ‘I don’t think we could find better care anywhere’ and ‘they do their jobs with loving care’. However, a couple of people were concerned about how busy the staff seemed at times and the amount of staff changes in the past few months, which is hard for the people living in the home. The manager explained about the staff changes, with fourteen people leaving in 12 months, and felt that the home was now more settled, offering some stability and continuity to the people living there. The home has access to the company bank staff at times of shortages, though has not needed this often recently, showing that they are meeting their minimum recommended staffing levels. Many of the new staff team were already well experienced having worked at other homes and are able to contribute to the team positively. They were clear about their roles and enjoyed their jobs, and felt that the training and support they got was excellent. The staff did appear to be Housteads DS0000002975.V347332.R01.S.doc Version 5.2 Page 18 relaxed and though busy, did not seem rushed in their work, making it easier for the older people in their care. They were able to facilitate social activities and trips to the hairdresser during our visit. It was acknowledged that there had been a period of significant change of staff and this had at times affected the home by increasing the workload, but that it had now settled, and they felt that they were able to improve the service such as improved activities. There were 92 of staff trained to level 2 NVQ or above, and all the others working towards it with an expected finish at the end of the year. This shows a commitment to training and development of staff that is reflected in the quality of care they provide. A sample of staff files were seen and contained evidence that a thorough recruitment procedure had taken place including checks on gaps in employment history, and other checks to safeguard the people living in the home. Evidence of supervisions, appraisals and refresher training was also seen showing that there is a continuation of staff development for all people working at the home, which helps to improve the quality of care to residents. Housteads DS0000002975.V347332.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): People who use the service experience excellent outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. We looked at outcomes for standards 31, 33, 35 and 38. People living in the home are safeguarded by the clear systems and approachable management style, that is influenced by the views of the people living at the home. EVIDENCE: The registered manager of the home is Martha Buchanon, who has the Registered Managers Award, is a Registered general Nurse, and has 7 years management experience, all relevant to the job she is doing. The atmosphere at the home was welcoming and friendly and people living in the home said that it was always like that, with managers and staff being approachable about anything they wanted to discuss. There are more formal ways that they can have their say such as at review meetings, through surveys, and at meetings. Housteads DS0000002975.V347332.R01.S.doc Version 5.2 Page 20 This was demonstrated as part of their quality assurance system that records these meetings and surveys and shows the action taken. Samples of financial records were seen and were recorded accurately, with evidence that they are monitored by the manager, showing that safe systems are in place. The management of the home carry out regular quality monitoring of different aspects of the home to ensure that the home does what it says it does for the people living there. All records seen were up to date and accurate showing a commitment to providing a good standard for the people in their care. Health and safety for people in the home is managed well by regular maintenance and checks on equipment, and the building. Staff members have appropriate training in fire safety, first aid, health and safety, moving and handling, and other areas to promote the safety and well being of the people in their care. Housteads DS0000002975.V347332.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 3 Housteads DS0000002975.V347332.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP19 OP26 OP26 Good Practice Recommendations The minor damage to bathrooms and toilet areas should be repaired and redecorated. The debris inside radiator covers should be cleaned and the covers made secure again. The storage of equipment in bathrooms should cease. Housteads DS0000002975.V347332.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR National Enquiry Line: 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 © 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 Housteads DS0000002975.V347332.R01.S.doc Version 5.2 Page 24 - 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. 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