CARE HOMES FOR OLDER PEOPLE
Midhurst Road 21 Midhurst Road Sheffield South Yorkshire S6 1EY Lead Inspector
Janice Griffin Unannounced 27 May 2005 7:00 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 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. Midhurst Road J55 2986 Midhurst V218781 27.05.05 UI Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Midhurst Road Address 21 Midhurst Road Sheffield S6 1EY Telephone number Fax number Email 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 2855 345 0114 2853 441 None South Yorkshire Housing Association Ms Tracey Payne PC Care Home only 42 Category(ies) of OP Old Age (42) registration, with number of places Midhurst Road J55 2986 Midhurst V218781 27.05.05 UI Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 1 March 2005 Brief Description of the Service: Midhurst Road is a residential care home for older people; it is registered to provide personal care and accommodation for 42 service users. South Yorkshire Housing Association provides the accommodation, and Sheffcare provide the care. Midhurst Road is situated in the North East of Sheffield in the district of Foxhill. Local public transport is available a short walk from the home. The home comprises of two levels with lift access to the upper level; and has four wings, two based on each level. The home is accessible for wheelchair users. The home is well decorated; all of the bedrooms are en-suite providing single accommodation. There is a suitable number of lounges and dining rooms. The homes gardens are very well maintained with views across the countryside and the home has a car park. Midhurst Road J55 2986 Midhurst V218781 27.05.05 UI Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over six hours from 7:00am to 13:15pm. Opportunity was taken to make a partial tour of the home and inspect a sample of records. The inspector spoke to twelve-service user, two relatives and five members of staff. What the service does well: What has improved since the last inspection?
Since the last inspection redecoration of some communal areas and some bedrooms had taken place. The service users said that the quality and choice of the food served at the home had “improved” over the past few months. Systems had been introduced to ensure that thorough and effective hygiene routines were maintained. Midhurst Road J55 2986 Midhurst V218781 27.05.05 UI Stage 4.doc Version 1.30 Page 6 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. Midhurst Road J55 2986 Midhurst V218781 27.05.05 UI Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Midhurst Road J55 2986 Midhurst V218781 27.05.05 UI Stage 4.doc Version 1.30 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 standard(s) Theses standards were not checked at this inspection they will be checked at the next inspection. EVIDENCE: Midhurst Road J55 2986 Midhurst V218781 27.05.05 UI Stage 4.doc Version 1.30 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 standard(s) 7,8 and 10. The service users said that the staff promoted their privacy and dignity and that their health care needs were met, they also said they received visits from health care professionals, including dental and optical treatment. The home used the services of a continence advisor and service users were provided with appropriate supplies. EVIDENCE: Three service users plans of care were checked. Each set out individual service users needs and the action required and taken by staff to ensure those needs were met. Discussion with service users identified that a range of health professionals visited the home to assist in maintaining health care needs. Staff interacted well with the service users, furthermore they were observed closing bedroom, toilet/bathroom doors when attending to service users personal care needs. All service users spoken to said that the staff treated them with respect and their right to privacy was always upheld. The staff said that service users post was only opened if the service user or their representative requested this. This promotes the privacy of service users. The home had a pay phone, which was situated, in a quiet area in the home, this also promotes service users privacy.
Midhurst Road J55 2986 Midhurst V218781 27.05.05 UI Stage 4.doc Version 1.30 Page 10 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 standard(s) 12,13,14 and 15. Service users were generally happy with their lifestyle within the home and they were able to maintain contact with family and friends. They also said that the staff try hard but sometimes they do not have enough time to help them to exercise more choice and control over their lives, as they always appeared very busy. The service users said that the food provided at the home had improved since the last inspection. EVIDENCE: Service users said that staff try hard to assist them to take up opportunities for personal development, including fulfilling spiritual needs. Examples of this were encouraging self help, decision making, inclusion into the community, having the same opportunity to experience everyday activities as afforded to other people and making choices about how they spend their time, where, and who with. This allows the service users to exercise some control over their lives. Relatives said that visiting times were flexible and that they could see the service users in private. Service users confirmed that staff helped them to maintain contact with their family/friends and that they could choose who to see and who not to see. This promotes the wellbeing of service users. Service users spoken to said the food served was good and hot food was served hot and that there was a good choice of food, which they enjoyed.
Midhurst Road J55 2986 Midhurst V218781 27.05.05 UI Stage 4.doc Version 1.30 Page 11 They confirmed they could have drinks and snacks when they wanted and that three full meals a day were offered. This promotes the health and wellbeing of service users. Midhurst Road J55 2986 Midhurst V218781 27.05.05 UI Stage 4.doc Version 1.30 Page 12 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 standard(s) 16 and18. The arrangements for protecting service users and responding to their concerns were satisfactory. Staff had a good understanding of the procedures to be followed should they suspect any abuse at the home. Discussions with service users confirmed they had nothing to complain about, they were ‘happy’ and ‘well looked after’. They did say however that there were not always enough staff on duty. This is addressed later in this report. EVIDENCE: Discussions with staff demonstrated they were confident in reporting any abuse should they become aware of it. Staff had received information and formal training on adult abuse, which gives them an understanding of the procedures to follow. Discussions with service users confirmed they were happy and well looked after and new who to complain to. Midhurst Road J55 2986 Midhurst V218781 27.05.05 UI Stage 4.doc Version 1.30 Page 13 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 standard(s) 19,24 and 26. The location and layout of the home is suitable for its stated purpose. Service users bedrooms met individual’s needs in a comfortable and homely way. Some service users said that they had not been offered a key for their bedroom doors. The home was clean and smelt fresh. Some of the string lighting cords were sticky and dirty. EVIDENCE: Service users said that the home was always clean and hygienic; this they said made them feel safe because the home was well looked after by the staff group. Since the last inspection corridors and some communal areas have been redecorated. This has markedly improved the environment at the home. Three bedrooms were checked in detail and many others seen, all were comfortable and homely. Service users spoken to said that they had all they wanted in their rooms. Midhurst Road J55 2986 Midhurst V218781 27.05.05 UI Stage 4.doc Version 1.30 Page 14 Some service users complained that other service users wandered into their bedrooms at night and they could not stop this because they did not have a key to lock their bedroom doors. This does not promote the safety and privacy of the service users. Some of the string lighting cords need replacing, to improve the hygiene standards. Midhurst Road J55 2986 Midhurst V218781 27.05.05 UI Stage 4.doc Version 1.30 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28 and 29. Service users consulted spoke very highly of the care provided by the staff, however several service users raised concerns about the staffing levels at the home. The current staffing levels had been agreed several years ago. The recruitment information obtained for new staff was sufficient to adequately protect the welfare of service users who lived at the home. EVIDENCE: Staffing levels at the home have not been reviewed for several years and the staff said that the service users that now live at the home were more dependants on them than they had been in the past. The service user agreed with the staff, they said they try very hard but they always seemed to be dashing around and did not have much time to speak to them or answer alarm buzzers quickly. Service users said this made them feel a burden on the staff. Three staff files checked confirmed that thorough recruitment procedures were carried out prior to employment being offered. This ensures that the service users are in safe hands at all times. The homes induction programme met required standard and staff spoken to said it covered such things as safe working practices, the organisation and workers role and the needs of the service users. This promotes the safety of staff and service user. Training needs of care staff were identified via supervision and appraisal sessions. Staff spoken to confirmed they receive much more than three days paid training, this demonstrates the provider’s commitment to investing in the staff. Midhurst Road J55 2986 Midhurst V218781 27.05.05 UI Stage 4.doc Version 1.30 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33, 37 and 38. The service users and staff said the manager was approachable and very professional. The service user said that they did benefit from good leadership and the management approach of the home. They also said they felt involved in the running of the home. The health, safety and wellbeing of service users were protected at all times. The service users case files were not securely stored. EVIDENCE: Staff spoken to had an understanding of the home’s fire procedures; they had received training on moving and handling, fire, food safety and infection control. This will ultimately benefit the health and welfare of the service users. There was a quality assurance system, which sought the views of service users. Midhurst Road J55 2986 Midhurst V218781 27.05.05 UI Stage 4.doc Version 1.30 Page 17 Service user meetings took place regularly both at the home and at other Sheffcare venues. Service users said this made them feel involved in the running of the home and that they could influence the quality of the care offered. Service users and their representatives were informed when CSCI inspections took place and had access to copies of the inspection reports. This ensures that the home is run in the best interest of service users. The manager on duty stated that there was a programme for the regular servicing and maintenance of gas and electrical appliances. No fire exits were blocked and hazardous substances were securely stored, maintaining service users safety. Some service users case files were insecurely stored. This does not safeguard the confidentiality of service users. Midhurst Road J55 2986 Midhurst V218781 27.05.05 UI Stage 4.doc Version 1.30 Page 18 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 3 x x x x 2 x 2 STAFFING Standard No Score 27 2 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 x x x 2 3 Midhurst Road J55 2986 Midhurst V218781 27.05.05 UI Stage 4.doc Version 1.30 Page 19 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. 3. Standard 24 26 27 Regulation 16 12 18 Requirement All service users must be offered a key to their bedroom doors. The dirty string light cords must be replaced. The current staffing levels must be reviewed, to ensure the staffing numbers are appropriate to meet the assessed needs of the service users.This requirement has been outstanding since 2004. Service users case files must be kept in a secure place at all times. Timescale for action Immediate 1/8/05 1/9/05 4. 37 17 Immediate 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 Good Practice Recommendations Midhurst Road J55 2986 Midhurst V218781 27.05.05 UI Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection 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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