CARE HOMES FOR OLDER PEOPLE
Paddock Hill 625 Gleadless Road Sheffield South Yorkshire S2 3RA Lead Inspector
Janice Griffin Unannounced 11 May 2005 9:00 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. Paddock Hill J55 S2997 Paddock Hill V218783 11.05.05 UI Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Paddock Hill Address 325 Gleadless Road Sheffield S2 3RA 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 239 1449 0114 239 2278 None Sheffcare Limited Miss Michelle Dent PC Care home only 40 Category(ies) of OP Old Age (40) registration, with number of places Paddock Hill J55 S2997 Paddock Hill V218783 11.05.05 UI Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 9 March 2005 Brief Description of the Service: Paddock Hill is a purpose built home on three floors all serviced by a lift. The home is set in pleasant gardens in the Gleadless area of Sheffield, within easy reach of the city centre. The home provides residential care for 40 elderly people. The communal areas are spacious and the property is situated on a main road close to shops, pubs, parks and post office. Paddock Hill J55 S2997 Paddock Hill V218783 11.05.05 UI Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over five hours between 9.00 am and 14:00pm. An inspection of most parts of the home and grounds was carried out. A number of records, relating to those living in the home and management paperwork were checked. Time was spent talking with groups of service users in communal areas and individually with ten service users. Time was spent observing the interaction between staff and service users. 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 care plans and individual risk assessments contain all the information as required by the regulations. Training and supervision has been provided to all care staff to ensure they lift service users correctly, speak appropriately to them and treat them in a respectful manner. Staff that administer medication stay with the service users to ensure that prescribed medication is taken by them. Service users have been seen by a manager of Sheffcare Ltd to establish if they have any complaints about the attitude of any staff members. Paddock Hill J55 S2997 Paddock Hill V218783 11.05.05 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. Paddock Hill J55 S2997 Paddock Hill V218783 11.05.05 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 Paddock Hill J55 S2997 Paddock Hill V218783 11.05.05 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) 1,2 and 3. The statement of purpose, service user guide and the contract of care provided sufficient information for prospective service users to make an informed decision about admission to the home. All the service users spoken to said that they had, their needs assessed prior to admission. The assessment of need forms included sufficient information for the staff to understand what services the service users would need at the home. EVIDENCE: The homes statement of purpose and service user guide, were informative and up to date, which helped service users to decide whether to accept a placement at the home. Service users said that they were admitted to the home after their needs had been assessed by a person qualified to do so. Staff at the home also complete their own assessments in sufficient detail to determine whether they could meet the prospective service users need, this allowed the service users to make an informed choice. Service users were encouraged to visit the home to meet people, see the facilities available and sample the hospitality. Paddock Hill J55 S2997 Paddock Hill V218783 11.05.05 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) 7,8,10 and 11. Care plans detailed a significant amount of information relating to health, personal and social needs. 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 were well dressed and confirmed that staff supported them with personal hygiene were necessary. The home had a policy for caring for service users at the time of death. 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 the needs were met. The care plans contained information about the service users preferences at the time of their death. This allowed the staff to treat the service users with respect and dignity at the time of death. Discussion with service users identified that a range of health professionals visited the home to assist in maintaining health care needs. Service users said they were treated with respect and their privacy was upheld which helped to make them feel comfortable and ‘at home’. Paddock Hill J55 S2997 Paddock Hill V218783 11.05.05 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. Activities that matched preferences and capabilities were on offer; activities and trips outside the home did benefit those service users who enjoyed being ‘active’ and ‘busy’. There were no restrictions on visiting times and service users were able to receive visitors in private. Meals were of a high standard and served in pleasant surroundings. EVIDENCE: Relatives were seen visiting freely and being offered hospitality, which creates a home that people want to visit. Bedrooms seen were personalised and observation of the interaction between service users and staff confirmed that personal autonomy and choice were well respected. This supported service users to exercise control and choice over their daily routines. The service users said the meals provided were always good and that individual food likes and dislikes were accommodated. This allowed the service users to exercise control over their diet. Paddock Hill J55 S2997 Paddock Hill V218783 11.05.05 UI Stage 4.doc Version 1.30 Page 11 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 and 18. Staff had an 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’. EVIDENCE: Service users said that if they had any concerns they would feel comfortable in talking to the staff or the manager. Complaints procedures and an ethos were in place to enable service users and relatives to feel confident that any concerns they voiced would be listened to. Staff had received formal adult protection training. This helps to ensure that service users are protected from abuse. Paddock Hill J55 S2997 Paddock Hill V218783 11.05.05 UI Stage 4.doc Version 1.30 Page 12 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 and 26. The location and layout of the home is suitable for its stated purpose, however some rooms need redecorating and some of the carpets replacing. Service users bedrooms met individual’s needs in a comfortable and homely way. The home was clean and smelt fresh. One toilet could not be used. 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 redecoration of some communal areas and bedrooms had taken place, but some areas still had damaged decoration and stained carpets, which made some areas look shabby. The service users said they were satisfied with their bedrooms, which they were able to personalise this they said made their rooms comfortable and homely. One toilet could not be used because the carpet was damaged and created a trip hazard for service users. Paddock Hill J55 S2997 Paddock Hill V218783 11.05.05 UI Stage 4.doc Version 1.30 Page 13 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) 27,28,29 and 30. Staff were employed in sufficient numbers to meet the needs of service users in accordance with agreed staffing levels. Service users spoken to said that staff were kind and helpful. The recruitment information obtained for new staff was not sufficient to adequately protect the welfare of service users who lived at the home. EVIDENCE: The manager stated that agreed staffing levels were being maintained. This assisted in making sure that service users needs were met. Three files checked confirmed that thorough recruitment procedures were not carried out prior to employment being offered. This does not ensure that the service users are in safe hands at all times. Staff training records identified a good range of training opportunities and all staff undertook an induction programme, which the manager stated, met the National Training Organisation (NTO) specifications. This demonstrates Sheffcares commitment to investing in the staff. Paddock Hill J55 S2997 Paddock Hill V218783 11.05.05 UI Stage 4.doc Version 1.30 Page 14 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 and 38. The service users and staff said the manager was approachable and very professional. The health, safety and wellbeing of service users were not protected at all times. EVIDENCE: There was a positive style of management in the home and staff moral had improved which will ultimately benefit the health and welfare of the service users. Arrangements for all staff to undertake fire training and the regular servicing of the homes equipment and appliances were satisfactory which assisted the protection of service users and staff from a risk of harm. The key was left in the door of a cupboard which contained hazardous substances and the lock on the door of the lift shaft was broken, this does not protect service users from harm. Paddock Hill J55 S2997 Paddock Hill V218783 11.05.05 UI Stage 4.doc Version 1.30 Page 15 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 3 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 1 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 Standard No 16 17 18 Score 3 x 3 3 x x x x x x 1 Paddock Hill J55 S2997 Paddock Hill V218783 11.05.05 UI Stage 4.doc Version 1.30 Page 16 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. Standard 19 Regulation 23 Requirement The stained decoration and carpets must be cleaned or replaced. This requiement has been outstanding since 2003. Two references must be obtained for all staff prior to being employed at the home. Hazardous substances must be securely stored at all times. This requirement has been outstanding since the inspection. The lift shaft door must be lept locked at all times. The carpet in the toilet must be replaced or secured to the floor. Timescale for action 1/7/05 2. 3. 29 38 18 12 Immediate Immediate 4. 5. 38 19 12 23 Immediate 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 Paddock Hill J55 S2997 Paddock Hill V218783 11.05.05 UI Stage 4.doc Version 1.30 Page 17 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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