CARE HOMES FOR OLDER PEOPLE
Prospect House Prospect Street Cudworth Barnsley South Yorkshire S72 8HE Lead Inspector
Christine Rolt Unannounced Inspection 23rd February 2006 09:30 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 Prospect House DS0000018267.V278702.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. Prospect House DS0000018267.V278702.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Prospect House Address Prospect Street Cudworth Barnsley South Yorkshire S72 8HE 01226 780 197 01226 780 197 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) Amocura Limited Miss Donna Louise Wood Care Home 34 Category(ies) of Dementia - over 65 years of age (18), Old age, registration, with number not falling within any other category (16) of places Prospect House DS0000018267.V278702.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. The DE(E) is a separate unit on the first floor The DE(E) unit may accommodate service users aged 60 years and above. Staffing levels must be maintained at, at least the minimum levels required by the April 2002 published Residential Forum, Care Staffing in Care Homes for Older People. The registered manager will work four days a week supernumerary. 4. Date of last inspection 29th September 2005 Brief Description of the Service: Prospect House is a purpose built care home providing accommodation and personal care for 34 persons. There are 16 resident places for old age and 18 places for old age with a mental disorder accommodated in a separate first floor unit. Accommodation is on two floors, served with a passenger lift. Car parking is provided at the front and rear of the home. There is an enclosed patio sitting area at the back of the home, which has benches and garden furniture with pots of bedding out plants for users to enjoy. The home is situated in the centre of Cudworth village, four miles from Barnsley. Within a short walk of the home, there is a busy High Street with a full range of amenities, which include a post office, supermarkets, cafes, an optician, a pharmacy, the local health centre, places of worship and a park. Prospect House DS0000018267.V278702.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection from 09.30 am to 12.20 pm, and was the home’s second inspection as required by law for the period April 2005 to March 2006. The main aims for this inspection were to cover key standards that had not been checked at the previous inspection, to check requirements made at the previous inspection, to sample records, observe routines within the home and to meet residents and staff. The majority of residents and staff were seen during the inspection and there was opportunity to speak to two residents, two visitors and a member of staff in detail. The manager Ms Donna Wood and the Responsible Individual Ms Maureen French, were in attendance throughout the inspection. What the service does well: What has improved since the last inspection? What they could do better:
A requirement was made at the last inspection for activities to be improved to meet the needs of the residents. There were no activities taking place during
Prospect House DS0000018267.V278702.R01.S.doc Version 5.1 Page 6 the inspection. The home employed an activities co-ordinator for 12 hours per week but the activities mentioned were not tailored to meet the needs of residents with dementia. Staff had received some information on the causes and types of dementia but would benefit from additional training to improve their awareness of residents’ needs and provide more stimulation for residents with dementia. The full list of menus was displayed but was in standard size print and could be confusing for residents, especially residents with dementia. Breakfast and tea provided a variety of options but lunch was a set meal. Alternatives were available for residents who did not want the meal on offer but the provision of an alternative to the set meal would provide a positive choice and promote residents’ choices. A requirement was made at the last inspection for improvements to be made in the recruitment process. There were still some aspects of this requirement that had not been met, insufficient references, discrepancy in information and no written record of follow up. The filing of staff information was disorganised and inefficient and it was recommended that improvements be made to ensure effectiveness and efficiency. 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. Prospect House DS0000018267.V278702.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 Prospect House DS0000018267.V278702.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): Standard 3 was checked at the previous inspection and the standard was met. The home does not provide intermediate care therefore Standard 6 is not applicable. EVIDENCE: Prospect House DS0000018267.V278702.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): 10 Residents were treated with respect. All other key standards were checked at the previous inspection and met the standards. EVIDENCE: The majority of residents were awake, alert and calm. Interactions, both verbal and non-verbal, were good between staff and residents and showed that residents were treated with respect. During a discussion with a member of staff, she spoke about various residents and their care needs and the ways of meeting their needs, which demonstrated that residents were treated as individuals. Two visitors said that the care was good and they were satisfied with the home. Prospect House DS0000018267.V278702.R01.S.doc Version 5.1 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 the following standard(s): 12, 14 and 15 Residents made some choices about their lives but there were insufficient activities to stimulate residents and improve their quality of life. Residents received a wholesome and balanced diet but there was no positive choice at the lunchtime meal. EVIDENCE: The majority of residents were sat in the lounges. No activities took place during the inspection. One resident said that there was not much to do and she spent most of her time just sitting. The manager said that an activity coordinator was employed for 12 hours per week and the activities included bingo, dominoes and Scrabble. The need to provide more person-centred activities, particularly for residents with dementia, was discussed. Two residents said that the food was good but did not know what they would be having for lunch. Breakfast and tea provided a variety of options, but lunch was a set meal. The manager said that they were aware of residents’ likes and dislikes and provided alternatives for residents who did not like the meal on offer. The provision of an alternative to the set meal was discussed as a means of promoting residents’ choices. The menus were displayed but were typed in
Prospect House DS0000018267.V278702.R01.S.doc Version 5.1 Page 11 standard print and could be confusing for residents to read. The use of a more visible menu board was recommended. Prospect House DS0000018267.V278702.R01.S.doc Version 5.1 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): The key standards 16 and 18 were checked at the previous inspection and met the standards. EVIDENCE: Prospect House DS0000018267.V278702.R01.S.doc Version 5.1 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 and 26 The home was clean, pleasant and hygienic but improvements could be made to the environment to make it more suitable for people with dementia. EVIDENCE: The home was clean and tidy. There were no offensive odours in the home. However, improvements could be made to the environment to make it more user friendly for persons with dementia. An example of this was that all doors leading from the corridor were indistinguishable from one another. Advice was given on how these could be improved to ensure better orientation for the residents. Prospect House DS0000018267.V278702.R01.S.doc Version 5.1 Page 14 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): 28, 29 and 30 Residents were not fully protected by the home’s recruitment practices. Staff would benefit from additional training in the care of people with dementia. Other key standards were checked at the previous inspection and met the standards. EVIDENCE: Three staff files were checked. The information in these files was disorganised, which was time consuming and meant that there was a greater chance of error that relevant documentation was not included. An example of this was that on one file there was only one reference, and there was a discrepancy between information on this reference and information on the application form. There was no written record that this discrepancy had been discussed with the employee. Advice was given on improvements to ensure that all relevant information was included. Staff had undertaken Criminal Record Bureau (CRB) disclosures at the correct level. One member of staff whose CRB disclosure was awaited, had evidence on file that a Protection of Vulnerable Adults (POVA) First check had been done. The manager said that this member of staff did not work on her own but was supervised at all times until they received the disclosure.
Prospect House DS0000018267.V278702.R01.S.doc Version 5.1 Page 15 A member of staff said that she had been on several training courses and that several others were imminent. The majority of these were mandatory health and safety courses ie moving and handling, fire safety etc. She had also received some training in the causes and types of dementia. However, it was unclear as to whether this training included residents’ perceptions of themselves and their environment and how to meet their needs (see Standard 19). The manager and the responsible individual agreed to look at providing more training in this area. Prospect House DS0000018267.V278702.R01.S.doc Version 5.1 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 and 36 A person who was fit to be in charge managed the home. Staff were appropriately supervised. Other key standards were inspected at the previous inspection and met the standards. EVIDENCE: The manager had recently attained the Managers Award. The senior member of staff on shift and ultimately the manager supervised members of staff. Records of staff supervision sessions were seen on staff files and a member of staff said that the supervision sessions included discussions about training matters, work practice and any problems encountered. Prospect House DS0000018267.V278702.R01.S.doc Version 5.1 Page 17 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 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 2 X X X X X X 3 STAFFING Standard No Score 27 X 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X 3 X X Prospect House DS0000018267.V278702.R01.S.doc Version 5.1 Page 18 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. Standard OP12 OP29 Regulation 16 19, Schedule 2 Timescale for action Activities must be improved to 19/05/06 meet the needs of the residents. Staff must not commence 21/04/06 employment without the receipt of two written references Gaps in employment must be investigated and the outcomes recorded. 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. 1 2 3 4 Refer to Standard OP15 OP15 OP19 OP29 Good Practice Recommendations The provision of an alternative to the set meal at lunchtime would provide a positive choice and promote residents’ choices. A clear, easy to read menu board would be more informative for residents. To make the environment more user friendly for residents with dementia. A better method of recording and filing information on staff members’ files would provide a more efficient and effective record.
DS0000018267.V278702.R01.S.doc Version 5.1 Page 19 Prospect House 5 OP30 Further training in dementia care would increase staff members’ knowledge and awareness of the needs of residents with dementia. Prospect House DS0000018267.V278702.R01.S.doc Version 5.1 Page 20 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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