CARE HOMES FOR OLDER PEOPLE
Paddock Hill 625 Gleadless Road Sheffield South Yorkshire S2 3RA Lead Inspector
Janice Griffin Unannounced Inspection 9th November 2005 08:00 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 Paddock Hill DS0000002997.V261456.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. Paddock Hill DS0000002997.V261456.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Paddock Hill Address 625 Gleadless Road Sheffield South Yorkshire S2 3RA 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 239 1449 0114 239 2278 Sheffcare Limited Miss Michelle Dent Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Paddock Hill DS0000002997.V261456.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 11th May 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 DS0000002997.V261456.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 8:00 am to 13:45 pm. As part of the inspection process fourteen-service users and seven staff, including the manager on duty, were spoken to. A number of records were examined and several areas of the building were inspected. The inspector was pleased to note that throughout the inspection staff interacted positively and sensitively with each service user who were obviously comfortable and at ease in the company of staff. The inspector would like to thank service users, the manager on duty and staff for their commitment to the inspection process. What the service does well: What has improved since the last inspection?
The home now operates thorough recruitment procedures and all of the required checks had been completed prior to staff commencing their employment at the home. Some areas have been redecorated and floor coverings cleaned or replaced. The door to the lift shaft has been made secure. Paddock Hill DS0000002997.V261456.R01.S.doc Version 5.0 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 DS0000002997.V261456.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 Paddock Hill DS0000002997.V261456.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): 4 and 5. Service users individual needs had been fully assessed prior to their admission, and they had moved into the home once it had been agreed that the home could meet their needs. Service users were able to have informal introductory visits to the home and at the time of their admission had been provided with a contract containing the relevant information. EVIDENCE: Detailed full needs assessments had been completed by the referring social worker for service users recently admitted to the home. Their 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.
Paddock Hill DS0000002997.V261456.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 Paddock Hill DS0000002997.V261456.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. Where appropriate service users were able to administer their own medication. The procedure in place to ensure the safe management of medication needs to be improved. Service users said that they were treated with respect and that their right to privacy was upheld. EVIDENCE: Systems were in place to ensure the safe administration and recording of medication, however medication was noted to be insecurely stored in one bedroom. This could be a safety hazard for service users. Records were kept of medication received into the home, of medication administered and returned. Controlled drugs were stored in double locked cupboard and two staff witnessed the administration of controlled drugs. The receipt, administration and disposal of controlled drugs were recorded in a controlled drugs register. Paddock Hill DS0000002997.V261456.R01.S.doc Version 5.0 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): These standards were not checked they were checked at the last inspection. EVIDENCE: Paddock Hill DS0000002997.V261456.R01.S.doc Version 5.0 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 the following standard(s): 17. Full records of all complaints made were available within the home. The CSCI as received no complaints about this home since the last inspection. The service users legal rights were protected. EVIDENCE: The manager said that several users had their legal rights protected by individual 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. Paddock Hill DS0000002997.V261456.R01.S.doc Version 5.0 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 the following standard(s): 19, 20, 21,22, 23, 24,25 and 26. All areas of the home seen were clean, homely and comfortable and provided safe access for service users. Some areas of the building were in need of redecoration. Effective cleaning routines were in place and the home had the appropriate policies and procedures to ensure the control of infection. The registered providers were keen to ensure that the home was well maintained and could meet service users individual needs. Locks were provided to bedroom doors and lockable facilities were provided in each bedroom. Paddock Hill DS0000002997.V261456.R01.S.doc Version 5.0 Page 14 EVIDENCE: Service users said that the home was always clean; this they said made them feel safe because the home was well looked after by the staff group. All areas were homely and attractive but some parts of the home had damaged decoration. Making some parts of the home look shabby. The bedroom doors were fitted with suitable door locks and lockable facilities were provided in all the bedrooms. Service users could choose to meet with their visitors in these rooms or in the privacy of their own bedroom. The appropriate seating had been provided in the garden for those service users wishing to sit outdoors whenever the weather permitted. The home had a number of toilets and bathrooms provided as required. Staff confirmed that all equipment was in good working order and that it had been serviced as required. Paddock Hill DS0000002997.V261456.R01.S.doc Version 5.0 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 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 29. The staff said that in the main, staffing levels were enough to meet the needs of the service users, but the high turnover of staff was a problem. Service users spoken to said that staff were kind and helpful. The home had a training and development plan and all staff had completed a range of training relevant to their role. The recruitment procedures were sufficiently robust enough to protect the welfare of service users. EVIDENCE: The staff said that in the main, staffing levels were enough to meet the needs of the service users. The staff said that during the last few months there had been a high turnover of staff. The staff said this was confusing for the service users. Service users said that staff were always there to help them and they felt safe. Three staff files were checked; the files did demonstrate a thorough recruitment process had been followed as required by the regulations. CRB checks had been done and two references obtained, no gaps were noted in staff’s employment history. Paddock Hill DS0000002997.V261456.R01.S.doc Version 5.0 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 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): 31,32,33,34,35,36,37 and 38. The service users and staff said the manager was approachable and very professional. Service users and relatives surveys had been completed and service users had regular opportunities to discuss and feedback their views of the service provided by the home. A representative from the organisation visits the home on a regular basis and a report is submitted following the visits. Records were in the main up to date and well organised. Improvements need to be made to the management of service users finances. More care needs to be taken with some health and safety issues and the storage of hazardous substances. Paddock Hill DS0000002997.V261456.R01.S.doc Version 5.0 Page 17 EVIDENCE: The manager had a job description that clearly defined her roles and responsibilities and staff were aware of her role. She is committed to ensuring that the home maintains and develops their high standards of care, she had completed regular internal audits on all aspects of the service provided by the home. The finance records of one service user was checked and receipts were not available for all transactions made on behalf of the service user. This does not protect the service user from financial abuse. Service users confirmed that they could see the manager when they wished and they said that she was very approachable and supportive. Feedback was being sought on a regular basis from service users, their families and social workers and other professionals involved with each individual. The manager confirmed that their views via questionnaires would be available within the home. Records were securely stored as required and those checked were accurate and up to date and in good order. Staff and service users confirmed that they had access to the appropriate records as required. The manager stated that there was a programme for the regular servicing and maintenance of all appliances. No fire exits were blocked and all fire doors were closing on their rebates. A fire officer had recently visited the home and made several requirements that were necessary to improve the fire safety procedures at the home. There was no evidence at the home to show that all the requirements had been actioned. The pharmacist had recently raised concerns about the safe storage of washing up liquid; the risk assessments seen did not include the safe storage of this substance. Steradent tablets were noted to be insecurely stored in some bedrooms. The fixed wiring had been inspected two years ago and the report written following the inspection had identified problems with the wiring in some parts of the home. The manager on duty was not sure whether the necessary repairs had been carried out. Paddock Hill DS0000002997.V261456.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 2 10 X 11 X 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 2 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 2 3 3 1 Paddock Hill DS0000002997.V261456.R01.S.doc Version 5.0 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 4. 5 Standard OP9 OP19 OP35 OP38 OP38 Regulation 13 23 13 12 12 Requirement Medication must be kept in a secure place at all times. The damaged decoration must be redecorated. Receipts must be available for all financial transactions made on behalf of the service users. Hazardous substances must be securely stored at all times. Requirements made by the fire officer and electrical engineer must be actioned. If the requirements have been actioned then evidence of this must be sent to the local office of the CSCI. The risk assessment for the washing up liquid must give instructions of the safe storage of the substance. Timescale for action 09/11/05 01/05/06 01/12/05 09/11/05 01/12/05 6 OP38 12 01/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Paddock Hill DS0000002997.V261456.R01.S.doc Version 5.0 Page 20 No. 1 Refer to Standard OP27 Good Practice Recommendations The organisation should make every effort to maintain a consistent staff team. Paddock Hill DS0000002997.V261456.R01.S.doc Version 5.0 Page 21 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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