CARE HOMES FOR OLDER PEOPLE
Sapling 372 Chessington Road West Ewell Surrey KT19 9EG Lead Inspector
Mr P Benthom Announced Inspection 27 June 2005 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. Sapling H58 H09 s38846 Sapling v231446 270605 Stage 4 unn.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Sapling Address 372 Chessington Road West Ewell Surrey KT19 9EG 020 8393 6731 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) Emas Ltd Ms Ligaya Holcroft CRH (PC) 4 Category(ies) of Learning disability over 65 years of age registration, with number LD(E)) 4. of places Sapling H58 H09 s38846 Sapling v231446 270605 Stage 4 unn.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: There are no conditions of registration Date of last inspection 25 October 2004 Brief Description of the Service: Sapling is a purpose built bungalow designed to care for the needs of four older men with learning disabilities. It is one of three similar services owned by EMAS Ltd and is situated in a residential avenue near to the town of Epsom. Sapling H58 H09 s38846 Sapling v231446 270605 Stage 4 unn.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The Home’s performance was measured against the National Minimum Standards for Care Homes for Older People. A tour of the premises took place and care, training and Health and Safety records were inspected. All Service Users were spoken with and staff on duty were spoken with and observed in carrying out their duties The home had a comprehensive statement of purpose, which accurately depicted the services provided by the home. However this is in need of some review particularly in terms of the respite care service that is available. The service plans in place were comprehensive and are reviewed on a regular basis to ensure that they accurately depict service users’ needs. The home provided a high level of personal support to service users. This was a commendable part of the home’s operation. Service users’ health needs were well met. Senior staff are trained in the administration of medication. The home has a thorough complaints procedure. What the service does well:
The homes admission policy and procedures ensured admissions were on the basis of a full needs assessment. Staff individually and collectively had the required level of skill and experience to deliver services and care in accordance with the home’s Statement of Purpose. Care planning involved consultation with service users and/or their representatives. Files sampled on the day of the inspection contained comprehensive care plans, which were regularly reviewed. Risk assessments were seen and proven to be accurate and up to date. Service users have the opportunity to exercise choices in their day to day lives. The home had a range of appropriate activities available to the service users. The complaint procedure was seen as part of the inspection process. The procedure was simple and clear and accessible to the service users and their representatives. The home was safe and well maintained, meeting service users’ needs in a comfortable and homely way. Service users’ rooms were furnished to a good standard and they were encouraged to bring with them personal belongings. Staff training-files were seen and there was good evidence of a range of courses attended. The home was observed to operate a recruitment procedure based upon equal opportunities and adequate checks, which promoted the protection of the service users.
Sapling H58 H09 s38846 Sapling v231446 270605 Stage 4 unn.doc Version 1.30 Page 6 Appropriate records were observed to be in place, which were well maintained and accurate. Service users and as appropriate, their representatives, were stated to be informed of their right to access information held by the home in personal records. 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. Sapling H58 H09 s38846 Sapling v231446 270605 Stage 4 unn.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 Sapling H58 H09 s38846 Sapling v231446 270605 Stage 4 unn.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, 2,3, 4, 5 and 6 Service users are admitted only following a full assessment undertaken by the proprietor who was able to demonstrate the homes capacity to meet the assessed needs. EVIDENCE: The proprietor stated that all newly admitted service users to the home receive a welcome pack that includes: objectives of the service, philosophy of care and the complaints procedure of the home. A copy of the statement of terms and conditions was sampled. Each service user was issued with a contract and a copy was observed in each service user personal file. There was evidence of a full comprehensive assessment procedure that was carried out by the owner and the manager of the home prior to admission. Service users and their families/representatives and relevant professionals are involved in the assessment process. Staff individually and collectively had the required level of skill and experience to deliver services and care in accordance with the home’s statement of
Sapling H58 H09 s38846 Sapling v231446 270605 Stage 4 unn.doc Version 1.30 Page 9 purpose. As part of the assessment staff explored specialist needs and needs specific to minority and ethnic communities where applicable. The proprietor stated that emergency admissions are not normally accepted. A period of four weeks trial period was standard practice. Prospective service users were given an invitation in order to meet staff and service users prior to admission. The current service user group have been kliving at the home since it opened in December 2003. Sapling H58 H09 s38846 Sapling v231446 270605 Stage 4 unn.doc Version 1.30 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 standard(s) 7, 8, 9, and 10 The systems for the administration of medication are good and there are positive links with local GP and district nursing services. EVIDENCE: Care plans were reported to be drawn up in consultation with service users and with their relatives/representatives. Care plans sampled were comprehensive and up to date; there was evidence that regular reviews took place. Encouragement and support was given to service users to promote independence within the limitation of each individual’s capabilities The acting manager stated that all service users were registered with the local primary care trust for the provision of general medical services. Sapling H58 H09 s38846 Sapling v231446 270605 Stage 4 unn.doc Version 1.30 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 standard(s) 12, 13, 14 and 15 Links with the local community are good and serve to enrich Service Users lives. EVIDENCE: The staff were seen to be encouraging Service users to make full advantage of all local amenities and facilities and Service Users seen on the day of the inspection were pleased to speak freely of the type of activities they become involved in. There was evidence on the day of the inspection were very much involved in pursuing outside and personal interests. Sapling H58 H09 s38846 Sapling v231446 270605 Stage 4 unn.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, 17 and 18 The home has a satisfactory complaints system that is made available to all Service Users and staff. EVIDENCE: The home has developed its complaints procedure to incorporate details of the Commission for Social Care Inspection. The homes policies and procedures include a protection of vulnerable adults policy and a whistle blowing policy. The protection of Vulnerable Adults forms part of the staff induction programme and the staff-training file contained details of all up to date training. The complaints procedure was found to be clear and easy to read. All Service Users are provided with details of the company’s complaints procedure. Sapling H58 H09 s38846 Sapling v231446 270605 Stage 4 unn.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, 20, 21, 22, 23, 24, 25 and 26 The standard of décor and equipment in this home is very good with evidence of improvement through continual maintenance and refurbishment. EVIDENCE: The location of the home is suitable for its stated purpose; it is accessible, safe and well maintained, meeting service users’ individual and collective needs in a comfortable and homely way. All areas were found to be clean, tidy and well organised. The garden was observed to be well maintained and easily accessible. The home had a spacious communal sitting room and a separate dining room. All areas met the required standard and were tastefully and elegantly decorated and furnished. All service users bedrooms had an en-suite facility that included: a toilet and wash hand basin. Specialist bathing facilities and additional toilets were
Sapling H58 H09 s38846 Sapling v231446 270605 Stage 4 unn.doc Version 1.30 Page 14 provided suitable to meet the needs of the service users and in close proximity to communal areas and bedrooms. All rooms were bright and adequately ventilated There were arrangements in place to control the temperature of the water to prevent legionella and scalding of service users. Standards of cleanliness in the kitchen in particular, were seen to be very high. Sapling H58 H09 s38846 Sapling v231446 270605 Stage 4 unn.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, 29 and 30 The staff team are committed to providing a high standard of care to the Service Users in this home. EVIDENCE: There is a very low staff turnover in this Home and there are appropriate training opportunities in place for all staff. and a commitment from the organisation to provide staff with a full and detailed training programme. The Home is committed to a rolling programme of NVQ training for all staff. Staffing levels comply with National Minimum Standards. There was evidence that a thorough recruitment process had been followed and that it met the National Minimum Standards for protection of Service Users. There are arrangements to carry out CRB checks and two written references are required for all staff. All staff have completed induction and foundation training. 60 of the staff team have undertaken Level 2 NVQ training. Sapling H58 H09 s38846 Sapling v231446 270605 Stage 4 unn.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, 34, 35, 36, 37 and 38 Management arrangements in this home are currently of a temporary nature as the registered manager is absent from the service. However the management is consistent and the acting manager is supported by the proprietor in providing clear and consistent leadership in the home with all staff illustrating an awareness of their roles and responsibilities. EVIDENCE: The registered manager is currently absent from the service due to an internal investigation being carried out relating to poor financial accounting procedures. There is a an acting manager in placer and the proprietor who is registered as manager for one of the other services in the group, is present in the home at some point of every day to offer support to the acting manager and staff team. There was a positive, friendly and relaxed atmosphere.
Sapling H58 H09 s38846 Sapling v231446 270605 Stage 4 unn.doc Version 1.30 Page 17 Service Users spoken with stated that they are content with the service provided. Service Users were observed to be settled and happy in their environment. Supervision records were seen indicating that a good supervision is in place. Similarly there is a thorough induction programme. The home has comprehensive employment policies. Records required for the protection of service users were well maintained, upto-date and accurate. The records of service users are secured in a lockable cupboard. There is a positive approach to health and safety in the home. Staff receive mandatory health and safety training as part of their induction. The provider organisation conducts an annual health and safety audit, to ensure compliance with current legislation. There is a comprehensive file with records of systems and equipment serviced or requiring service. There were no identifiable Health and Safety issues apparent during this Inspection, and Safety Checks on equipment and Services such as Gas and Electricity are regularly undertaken. Sapling H58 H09 s38846 Sapling v231446 270605 Stage 4 unn.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 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 3 3 3 3 3 3 Sapling H58 H09 s38846 Sapling v231446 270605 Stage 4 unn.doc Version 1.30 Page 19 no Are there any outstanding requirements from the last inspection? 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 Regulation Requirement There are to be no requirements from this inspection Timescale for action 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 There are to be no recommendations from this inspection. Sapling H58 H09 s38846 Sapling v231446 270605 Stage 4 unn.doc Version 1.30 Page 20 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
© 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 Sapling H58 H09 s38846 Sapling v231446 270605 Stage 4 unn.doc Version 1.30 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
