CARE HOMES FOR OLDER PEOPLE
Midhurst Road 21 Midhurst Road Sheffield South Yorkshire S6 1EY Lead Inspector
Janice Griffin Unannounced Inspection 6th December 2005 09:00 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 Midhurst Road DS0000002986.V268607.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 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 DS0000002986.V268607.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Midhurst Road Address 21 Midhurst Road Sheffield South Yorkshire S6 1EY 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 285 5345 0114 221 3274 South Yorkshire Housing Association Ms Tracey Payne Care Home 42 Category(ies) of Old age, not falling within any other category registration, with number (42) of places Midhurst Road DS0000002986.V268607.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 27th May 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 are 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 DS0000002986.V268607.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place from 09:00 am to 2:20 pm. As part of the inspection process the inspector spoke to fifteen service users, two relatives, six staff and the registered manager. A number of records were examined and several areas of the building were inspected. The inspector would like to thank service users, the relatives, the staff and the manager for their openness and for their commitment to the inspection process. The inspector was pleased to note that service users spoke positively of the ongoing support provided by the staff. Observations confirmed that service users 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. What the service does well:
The home is welcoming, homely and has a relaxed atmosphere. Service users appeared comfortable sharing their views regarding the quality of the service provided. Service users said they were comfortable and happy with their rooms that they could organise and decorate as they wished. They also confirmed that staff gave priority to the personal and health care needs of each person. Service users were able to visit the home for trial periods and they were only admitted once it had been determined that the home could meet their needs and all service users currently living at the home were happy with the arrangements. The personal care needs of each individual had clearly been identified and the manager and staff work positively and proactively to ensure that they addressed these needs. All service users attended a good variety of social and leisure activities and these were based very much on the personal preferences of each individual. Visitors to the home were actively encouraged and service users were supported to maintain and develop links with their families and friends. One relative who visited his parents weekly travelled from the south of England, he was encouraged to stay at the home overnight with his parents. The service users were very happy with this arrangement. Discussions with service users, relatives and observations of their interaction with the staff confirmed that the home is very well managed and staffed. Newly recruited staff had completed detailed induction training. Midhurst Road DS0000002986.V268607.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. Midhurst Road DS0000002986.V268607.R01.S.doc Version 5.0 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 Midhurst Road DS0000002986.V268607.R01.S.doc Version 5.0 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 Service users individual needs had been fully assessed prior to their admission to the home. Admissions had been planned in detail once the home had determined that they could meet the individual’s needs. Service users were able to have an informal introductory visit at the home prior to their admission to ensure that they were fully aware of the terms and conditions of their stay. EVIDENCE: Detailed full needs assessments had been completed by the referring social worker for all service users admitted to the home. Families had been involved in the assessment process as appropriate. The manager confirmed that service users were only admitted to the home once they were sure that they could meet their needs. Service users were able to visit the home for informal visits prior to their admission if they wished. Service users confirmed that this helped them to get to know everyone at the home, which made them feel less anxious. Records checked confirmed that service users families had been involved in decisions regarding the arrangements.
Midhurst Road DS0000002986.V268607.R01.S.doc Version 5.0 Page 9 An up to date contract/statement of terms and conditions had been provided to service users and signed copies were retained on individual files. These clearly detailed the fees, including any extra charges, and the services and facilities provided by the home Midhurst Road DS0000002986.V268607.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9 and 11 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. Service users, where appropriate, can take responsibility for their own medication and were protected by the homes policies and procedures for administration, safe keeping, recording and disposal of medication. The home had a policy for caring for service users at the time of death. EVIDENCE: Discussion with service users identified that a range of health professionals visited the home to assist in maintaining health care needs. Service users who were able could retain control of their own medication, a lockable facility was provided to store such items. This allows service users to have control over their own medication. Records were kept of medication received, and disposed of. A pharmacist had checked the home’s medication systems at regular intervals. Midhurst Road DS0000002986.V268607.R01.S.doc Version 5.0 Page 11 The home had a policy on death and dying, which assured the service users that at the time of death staff would treat them, their family and friends with care sensitivity and respect. This was reassuring to relatives and service users. Midhurst Road DS0000002986.V268607.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not checked at this inspection they were checked at the last one. EVIDENCE: Midhurst Road DS0000002986.V268607.R01.S.doc Version 5.0 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): 17 The service users legal rights were protected. EVIDENCE: The manager said that nine-service user had their legal rights protected by their families, solicitors or the court of protection. She also said that if any other service users requested access to advocacy services then she would facilitate the service for them, if requested. The homes accounts had been audited. Midhurst Road DS0000002986.V268607.R01.S.doc Version 5.0 Page 14 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): 19,24 and 26 All areas seen were homely, comfortable and fresh smelling. Bathrooms and bedrooms had the appropriate locks fitted to ensure the privacy of service users. Service users had access to communal areas that were homely and included domestic style furniture and fittings. All areas of the home checked were clean. EVIDENCE: Since the last inspection two bedrooms had been redecorated and new carpets fitted, the manager confirmed that service users had been included in the decisions regarding colour schemes. Midhurst Road DS0000002986.V268607.R01.S.doc Version 5.0 Page 15 Three bedrooms were checked in detail and many others seen, all were comfortable and homely. Service users spoken to said they were satisfied with their bedrooms, which they were able to personalise this they said made their rooms comfortable and homely. All the service users had been offered a key to their bedroom doors. The home had an appropriate amount of sitting, recreational and dining space and there were sufficient rooms for a variety of activities to take place. Outdoor space and all areas of the home were accessible to people in wheelchairs. Two waste bins were not fitted with lids, this is not hygienic. Midhurst Road DS0000002986.V268607.R01.S.doc Version 5.0 Page 16 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 and 30 Service users consulted spoke very highly of the care provided by the staff, they also said that the staffing levels at the home were now much better. Staff had a wide range of abilities, knowledge, skills and experience and service users said they were well supported. Staff had a clearly defined job description and service users were aware of the roles and responsibilities of staff including the managers. The manager has undertaken an in-house review of the staffing levels. The home had a training and development plan and all staff had completed a range of training relevant to their role. EVIDENCE: The service users said that there was always enough staff on duty now. They added that staff worked very hard and described them as “very caring” “kind” “understanding” and added that staff treated them like human beings they were not intrusive and that you could have a joke with them. The manager had recently undertaken an in-house review of the staffing levels and the outcome was that the existing staff levels were adequate to meet the needs of the current service user group. This is good management practice. Midhurst Road DS0000002986.V268607.R01.S.doc Version 5.0 Page 17 Staff files and discussions with the staff and the manager confirmed that all staff had completed detailed induction training. Staff were approachable and sensitive to the needs of service users and were able to communicate effectively with each person. Staff had completed training on NVQ in care and this had ensured that more than 92 of the staff team were qualified to level 2/3. 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 DS0000002986.V268607.R01.S.doc Version 5.0 Page 18 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): 31,34,35,37 and 38 Service users benefited from a home that is well run by the registered manager. The service users and staff said the manager was approachable and very professional. Service users were benefiting from the care given by welltrained staff. Records were in the main up to date and well organised but some were noted to be insecurely stored. The homes policies and procedures met the required standards. A safe environment was not provided in all parts of the home. 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 DS0000002986.V268607.R01.S.doc Version 5.0 Page 19 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. This ensures that the home is run in the best interest of service users. 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. The manager handles money on behalf of some service users, account sheets were kept, receipts were available for all transactions and all transactions were witnessed by a second individual. The accounts were audited each year. One member of staff was observed pushing service users around the home in a wheelchair, there were no footplates fitted. This does not maintain the service users safety. Midhurst Road DS0000002986.V268607.R01.S.doc Version 5.0 Page 20 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 X 8 X 9 3 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 3 18 X 3 X X X X 3 X 2 STAFFING Standard No Score 27 3 28 X 29 X 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X 3 3 X 2 2 Midhurst Road DS0000002986.V268607.R01.S.doc Version 5.0 Page 21 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 OP24 OP37 OP38 Regulation 16 17 13 Timescale for action All waste bins must be fitted with 27/01/06 secure lids. Service users case files must be 06/12/05 kept in a secure place at all times. Footplates must be fitted to all 06/12/05 wheelchairs. Requirement 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 Good Practice Recommendations Midhurst Road DS0000002986.V268607.R01.S.doc Version 5.0 Page 22 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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