Inspection on 02/05/06 for Ideal Home

This inspection was carried out on 2nd May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Ideal Home 19/11/08

Ideal Home 21/05/08

Ideal Home 22/05/07

Ideal Home 03/11/05

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Ideal Home Knowsley Drive Gains Park Shrewsbury Shropshire SY3 5DH Lead Inspector Karen Powell Key Unannounced Inspection 2nd May 2006 10:45 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 Ideal Home DS0000064647.V290246.R01.S.doc Version 5.1 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. Ideal Home DS0000064647.V290246.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Ideal Home Address Knowsley Drive Gains Park Shrewsbury Shropshire SY3 5DH 08706092432 08706092435 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) Minster Care Management Limited Pamela Johnson Care Home 50 Category(ies) of Dementia (12), Mental disorder, excluding registration, with number learning disability or dementia (26), Old age, of places not falling within any other category (6), Physical disability (6) Ideal Home DS0000064647.V290246.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. That the manager seeks further knowledge and training in the areas of mental illness with respect to a care home and the individuals in residence. 3rd November 2005 Date of last inspection Brief Description of the Service: Ideal Home is situated in the village of Gains Park approximately 5 miles from the centre of Shrewsbury. It is located in a residential area, within walking distance of a local post office, shops and pub, with its own car parking and gardens. It is a private care home registered to provide care and accommodation for up to 50 people, including people with a mental disorder, both under and over 65 years old, elderly people and a small number of people with a physical disability. Minster Care Management Limited has recently acquired the business. Ms Pamela Johnson is the registered manager and is responsible for day-to-day running, staffing and the development of effective policies and procedures within the home. The accommodation has 3 fairly distinct areas, the main house and converted coach house, which provide accommodation on ground and first floors and a purpose built extension to the rear of the property, which is all on one level. Ideal Home DS0000064647.V290246.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was an unannounced key inspection carried out by two inspectors. The inspection lasted five hours. There were 45 service users resident at the time of the inspection. The inspection included discussion with service users, one relative and staff members, together with observation of daily routines, examination of service user and staff records, policies and procedures, and a home tour. The manager was on holiday at the time of the inspection. The inspectors were welcomed by the homes administrator Debbie Byrne and senior care assistant Caroline Abel. Service users greeted inspectors warmly and were seen to be relaxing throughout the home engaging in conversation and going about their daily routines. Accommodation charges are as follows: single room £387.50 per week and £335.00 for a shared room. What the service does well: What has improved since the last inspection? Minster Care Management Limited has owned Ideal Home for approximately eleven months. It is apparent they have a commitment to improving standards by the progress they have made to date. The company has worked well with the Commission for Social Care Inspection to meet requirements made within timescales set. Ideal Home DS0000064647.V290246.R01.S.doc Version 5.1 Page 6 All requirements made at the last inspection have been achieved. A tour of the home confirmed that improvements to bathing facilities, service user furniture and equipment have been completed. 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. Ideal Home DS0000064647.V290246.R01.S.doc Version 5.1 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 Ideal Home DS0000064647.V290246.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A suitably qualified person assesses all service users prior to moving in to the home, ensuring that admissions are appropriate and that needs can be met EVIDENCE: Service user files selected to monitor the assessment procedure carried out at the home were all seen to contain appropriate assessments which had been carried out prior to the individual moving into the home. Evidence that the home involves health and social care professionals who are also involved with the service user were also seen to be obtained prior to the service user moving into the home. Assessments were detailed and well documented, signed and dated. Ideal Home DS0000064647.V290246.R01.S.doc Version 5.1 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a clear care planning process in place and this, together with the involvement of health care professionals, ensures that service users’ health and social needs are met. Medication is dealt with safely in accordance with the homes policies and procedures. Service users’ privacy and dignity is maintained by the staff group EVIDENCE: Each service user has a plan of care. Four care plans were examined to monitor the care planning process. These included service users with a range of differing needs. Standards of care plans were good and included in detail how service users needs should be met. Reference to service users preferred terms of address were noted and these were heard to be referred to with Ideal Home DS0000064647.V290246.R01.S.doc Version 5.1 Page 10 service users. Care plans demonstrated the importance of maintaining service user dignity. Daily records noted care tasks carried out with service users and it was observed that where service users had chosen not to have personal care carried out, this was respected. This indicated choice being respected by the care team. One service user who was happy to speak to the inspector was going for a bath during the afternoon inspectors visited. They told the inspector that they ‘fancied a cup of tea before the bath’, and the carer had gone to make one, once again respecting service user choice. Care plans showed evidence of review, and the involvement of service users key workers at reviews. These were well recorded and included complimentary comments from service users about their care and contentment of living at Ideal Home. Evidence of service user health care needs being met was clearly documented in service user records, and confirmation of this was given through discussion with service users. One service user’s relative expressed their satisfaction with the care their relative is receiving and has noted improvements since the new owners have taken over. Service users and one relative who was visiting at the time of the inspection were positive in their comments with regard to the standard of care delivered by the care team. Medication was observed to be handled in accordance with the homes policies and procedures. Medication administration charts included a photograph of each service user. A sample of all staff signatures that administer medication was seen. A monitored dosage system is supplied by Boots the chemist. The senior member of staff spoken to about procedures was knowledgeable about the system. Medication storage was clean and well organised. Ideal Home DS0000064647.V290246.R01.S.doc Version 5.1 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individuals are encouraged to exercise choice in relation to daily living. Contact with family and friends is encouraged and supported by the staff group. Service users are offered a varied well balanced diet, which takes into account individual’s likes and dislikes along with seasonal changes. EVIDENCE: As reflected in the previous set of outcomes for service users it is evident that service users choice is promoted throughout aspects of daily living. Service users were seen during the inspection coming and going both inside and outside the home. A small number of gentleman were observed to be enjoying conversation and a cigarette in an outer area of the home. While others were seen in the designated smoking room. Service user records contained information relating to family visits. It was pleasing to see that one family had telephoned the home to share the news of a ‘new arrival’ in the family. Ideal Home DS0000064647.V290246.R01.S.doc Version 5.1 Page 12 A range of activities take place with service users, records of these were seen during examination at the inspection. Service users were seen going out into the community and as stated earlier one service user was seen receiving relatives during the inspectors visit. Other service users spoken to said that they also received visitors. The mobile library visits on a regular basis and a daily Shropshire Star is purchased for service users to read. Service users spoken to said that the quality of food was good. One service user was seen eating lunch later than the normal time, once again demonstrating service user choice being respected. The individual was pleased with the quality of the food at the home. The individual was a young person with a good appetite. The portion size was appropriate for their needs. Discussion with the cook took place. They explained that staff discuss the next days menu with service users. Individuals can visit the kitchen and request special requirements/arrangements for meals. The menu is on a two-week rolling programme to incorporate seasonal changes. The kitchen has been refurbished and was clean and well organised. Ideal Home DS0000064647.V290246.R01.S.doc Version 5.1 Page 13 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is a clear complaints system in place. The arrangements for the protection of service users from abuse are satisfactory, but all staff need to be aware of procedures in order to protect service users fully EVIDENCE: There is a clear complaints procedure in place. A copy is included in the service user guide for service users’ information. A copy of the service user guide and statement of purpose is available in the reception area. The senior carer on duty at the time of the inspection stated that she was not aware of any complaints since the last inspection. Examination of the central complaints record took place and there were no recorded complaints. There have been no complaints to the Commission for Social Care Inspection. Appropriate polices and procedures are in place at the home for the protection of adults. All newly appointed staff attend induction training, which includes the topic of abuse. However, for the two newest recruited staff induction records were incomplete. For one member of staff abuse training was not signed off as being undertaken. This was followed up by the inspector through discussion with the staff member to ascertain what training they had Ideal Home DS0000064647.V290246.R01.S.doc Version 5.1 Page 14 completed. This did not include abuse training. The home must ensure that each member of staff receives abuse training irrespective of their job role. A further staff file examined showed abuse training was carried out in 2003. This is in need of updating. Ideal Home DS0000064647.V290246.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Minster Care Management Limited continue to improve the environment by an ongoing refurbishment programme. EVIDENCE: Completion of work in relation to a refurbishment of two WC’s and a bathroom with shower cubicle has now been finished. Furniture in the coach house has now been upgraded. Service users now have lockable storage space. Bedside lighting or over bed lighting has been provided to those service users who wish to have it. During the home tour, which formed part of the inspection, it was noted that in room 8 there was a large hole in the wall. This must be repaired. Ideal Home DS0000064647.V290246.R01.S.doc Version 5.1 Page 16 A tea urn stands unsecured outside the kitchen. Whilst this appeared to be a well used facility it must stand securely and an accompanying risk assessment for its use be in place. This could not be located on the day of the inspection. There are two broken window stays in the smoking room. These must repaired/replaced as security to the building is at risk. The storage room next to the office in the loft should be free from clutter, which may pose a fire risk to the home. All areas of the home seen on the home tour were clean. Adequate numbers of housekeeping staff were seen on duty during the inspection. Domestic staff were seen wearing appropriate protective clothing whilst carrying out their duties. It was noted when examining staff training files that the laundress and one of the domestic staff files did not contain any evidence of infection control training. Given the importance of their role, and the need for good infection control procedures being in place it should be considered as part of the housekeeping teams training programme. Ideal Home DS0000064647.V290246.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is staffed by a competent and stable staff group. Recruitment procedures have not been consistently followed resulting in service users potentially being placed at risk from staff members who have not been properly vetted. Staff are supported to undertake training to enable them to confidently care for the service users living at the home. EVIDENCE: Examination of the rotas confirmed that there were satisfactory numbers and skill mix of staff on duty to meet the needs of the current service user group. However for the period examined April-May 2006 it was observed by inspectors that on some days staff work for 14-hour shifts. Four individuals on one Saturday and Sunday were working long days, either morning to twilight or twilight to nights. One day in the week five members of staff worked a long day. Concerns were raised at the time of the inspection with the senior carer regarding the physical well being of staff and their ability to provide care effectively for service users when working such long hours on a regular basis. Ideal Home DS0000064647.V290246.R01.S.doc Version 5.1 Page 18 Evidence on staff training files showed that staff are supported to undertake training. Courses included risk assessment, challenging behaviour and food hygiene. Two of the longer serving members of staff both held NVQ awards. Discussion with the training officer indicated that she works 35 hours per week and two hours are designated to training. She acknowledged there is a backlog of work to be undertaken. She has discussed having designated time with the manager. This is to be discussed with Minster Care Management Limited. She was happy to tell inspectors that ‘this is the best place I have worked’, a comment echoed by other members of staff spoken to during the inspection. A discussion with the cook also took place during the inspection. She stated that she has received training relevant to her role. As highlighted earlier in the report under standard 26 all staff must undertake abuse training and infection control training relevant to their role. Files of the two newest recruits to the home were examined to monitor the homes recruitment procedures. It was noted that the home had not carried out CRB checks prior to the individuals commencing employment. A POVA first, with required safeguards, followed by an enhanced CRB must be carried out on all new staff members before commencement of employment. Ideal Home DS0000064647.V290246.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The company continues to develop and maintain a well-supported staff group and are continually working towards improving standards. The health, safety and welfare of service users is protected by systems implemented to promote safe practises of work are followed within the home. EVIDENCE: Ms Pamela Johnson continues to manage the home. Although not present at the inspection it was clear she has a knowledgeable senior team who manage in her abscense. A telephone call to Ms Johnson upon her return from annual leave took place. She told the inspector that she is booked onto an introduction Ideal Home DS0000064647.V290246.R01.S.doc Version 5.1 Page 20 to mental health half-day course in June. The course is being run by County Training. Service users spoken to during the inspection were complimentary of Ms Johnson and her team. One service user’s records of financial transactions were examined at the inspection. These were seen to be satisfactory. Records of staff supervision were examined and demonstrated supervision is carried out on a regular basis. Records were clear and well organised. Staff confirmed supervision is carried out on a regular basis. The fire officer visited in October 2005, a copy of the visit was available to CSCI for this inspection. Four requirements were made as a result of that visit. A discussion with the handyman and checks for progress on these requirements were completed during the inspection. All had been completed with the exception of one sign for an emergency exit in the extension corridor being displayed. It was agreed this would be carried out. Minster Care Management Limited continue to work to achieve national minimum standards with a committed manager and staff team. Ideal Home DS0000064647.V290246.R01.S.doc Version 5.1 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 3 x 3 Ideal Home DS0000064647.V290246.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? NO Ideal Home DS0000064647.V290246.R01.S.doc Version 5.1 Page 23 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. 3. 4. 5. Standard OP18 OP19 OP19 OP19 OP29 Regulation 18 (1) (a) 23 (2) (b) 23 (2) (b) 23 (4) (a) Schedule 2 19(5)(d) 8 (1) (a) Requirement All staff must undertake abuse training. The hole in the wall in room 8 must be repaired. The two window stays in the smoking room must be replaced/repaired. The storage room in the loft must not pose a fire risk. A CRB disclosure or POVA 1st check followed by a CRB disclosure must be obtained before employing staff. Infection control training must be carried out with all staff at a level appropriate to their role. Timescale for action 02/07/06 02/06/06 02/06/06 02/06/06 02/06/06 6. OP30 02/08/06 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 Refer to Standard OP27 Good Practice Recommendations A review of staff working 14-hour shifts is undertaken. Ideal Home DS0000064647.V290246.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE National Enquiry Line: 0845 015 0120 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 Ideal Home DS0000064647.V290246.R01.S.doc Version 5.1 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!