Inspection on 17/09/08 for Scotia Heights

This inspection was carried out on 17th September 2008.

CSCI found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Scotia Heights 02/10/09

Scotia Heights 19/09/06

Similar services:

Aston Court Nursing Home

Breme

Ravenhurst

Westmead

Ashcroft Hollow Nursing Home

Bricklehampton Hall Nursing Home

Briar Hill House

Radbrook Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 05/12/2008.

CARE HOME ADULTS 18-65 Scotia Heights Scotia Health Care Ltd Scotia Road Burslem Stoke on Trent ST6 4ET Lead Inspector Yvonne Allen Unannounced Inspection 17th September 2008 09:00 Scotia Heights DS0000064684.V372287.R01.S.doc Version 5.2 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 Scotia Heights DS0000064684.V372287.R01.S.doc Version 5.2 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 Adults 18-65. 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. Scotia Heights DS0000064684.V372287.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Scotia Heights Address Scotia Health Care Ltd Scotia Road Burslem Stoke on Trent ST6 4ET 01782 829100 01782 829101 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) Email - scotia@exemplarhc.com Scotia Health Care Ltd Mr David Joseph Price Care Home 60 Category(ies) of Physical disability (60) registration, with number of places Scotia Heights DS0000064684.V372287.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide personal care with nursing and accommodation for service users of both sexes whose primary care needs on admission to the home are within the following categories: physical disability, which will include service users who additionally have mental health care, needs, PD, 60. The maximum number of service users to be accommodated is 60. 2. Date of last inspection 19th September 2006 Brief Description of the Service: Scotia Heights is a purpose-built specialist nursing home providing 60 beds for young adults. The new registration was approved on 10th February 2006 and admission of residents commenced shortly afterwards. The home provides holistic care for adult people aged between 18-65 years of age with a neurological diagnosis. The client group is people with a primary need of physical disability, with or without associated mental health problems. The home has currently applied for a variation to its Registration. The variation is to enable the home to widen the category of the client groups by having ten beds registered for mental disorder. The environmental facilities are excellent. - All bedrooms are for single use, spacious, having en-suite facilities including shower and all bedrooms have TV and telephone points. There is ample room to negotiate moving equipment as required. There are 12 lounges and 6 dining areas providing high-quality accommodation furnished and equipped to the highest standards and allowing small group living areas. Corridors are wide and spacious with recessed seating areas and there are rooms for visitors and meetings. All facilities, including kitchen, laundry and office accommodation are spacious, bright, well equipped and pleasing in presentation. The home is located in a well-populated area in the northern part of Stoke on Trent. It is on a main bus route and easily accessible by car or public transport to the Potteries towns where all communal facilities can be accessed. The home is located next to a modern leisure centre offering excellent facilities. At the date of this inspection, the fees charged by the home range from £1030.00 to £2537.40 per week. These should be discussed with the Registered Manager in the first instance, as Scotia Heights DS0000064684.V372287.R01.S.doc Version 5.2 Page 5 fees are very much dependent on individual needs and available funding. Scotia Heights DS0000064684.V372287.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 stars. This means that the people who use this service experience excellent quality outcomes. The inspection process commenced several weeks prior to the visit. The visit to the home was carried out over two days by one inspector. Prior to the inspection visit the Providers had completed a self-assessment tool, which is known as the Annual Quality Assurance Assessment (AQAA). Completion of the AQAA is a legal requirement and it enables the service to under-take a self-assessment, which focuses on how well outcomes are met for people using the service. This AQAA was very detailed and gave us good information about the services offered. All of the Key minimum standards were assessed and for each outcome a judgement has been made, based on the evidence gathered. These judgements tell us what it is like for the people who live in this home. The ways in which in we gathered evidence to make our judgements were as follows – We looked at any information we had received about the home since the last Key Inspection. This included any complaints and Safeguarding referrals we had received. We spoke with the people who live in the home including their representatives. We spoke with the staff who work at the home Discussions were held with the Registered Manager and Clinical Manager. We examined relevant paperwork and documentation at the home. We walked around the home. At the end of the inspection visit we discussed our findings with the Registered Manager and Clinical Manager. All the outcome areas have been assessed as excellent with one good. We have not made any requirements or recommendations as a result of this inspection. Scotia Heights DS0000064684.V372287.R01.S.doc Version 5.2 Page 7 What the service does well: What has improved since the last inspection? The home now employs a full time training manager to plan and deliver the staff training and development programme. Scotia Heights DS0000064684.V372287.R01.S.doc Version 5.2 Page 8 Two physiotherapists are employed by the home to work with people and to help promote mobility and independence. The home has provided two minibuses so that people can enjoy trips out and/or be taken for outpatient appointments. The manager informed us that the home had just been awarded as “The preferred providers to the Multiple Sclerosis Society”. He said that this process of auditing had taken 12 months and had been a very comprehensive audit. The home had also achieved the “Top 5 Dignity and Care Awards” for StokeOn-Trent. Keele University now places Student Nurses and Medical Students at the home for work placements. 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. The summary of this inspection report can be made available in other formats on request. Scotia Heights DS0000064684.V372287.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Scotia Heights DS0000064684.V372287.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): We assessed Standards 1, 2 and 3. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Significant time and effort is spent planning to make admission to the home personal and well managed. People wishing to move into this home and their families are treated as individuals and with dignity and respect for the lifechanging decisions they need to make. EVIDENCE: In their AQAA the Providers tell us that the home has a clear policy in equality and diversity and carries out pre-admission assessment to ensure all needs are met. The Home policy ensures that all new potential users of the service stay overnight and are encouraged to maximise their abilities. Staff visit people before their admission to the home and all members of the families are invited. Providers invite people to have a trial stay at the home. Scotia Heights DS0000064684.V372287.R01.S.doc Version 5.2 Page 11 There is a compressive assessment before admission and a comprehensive care plan developed. People are given an informative statement of purpose. We were given copies of the Statement Of Purpose (SOP) and Service User Guide (SUG). These documents are comprehensive and very specific to the needs of the people for which the home is registered. The SOP is very individual and talks of “your room” and “your needs”. This document goes on to say – “a comprehensive pre-admission process is carried out, comprising of a full assessment of service user needs and future aspirations. Service user and family involvement in this process is actively sought”. The SUG tells people that the home will – “Carry out a pre-admission assessment to ensure that your needs can be met within the home.” During the inspection process the above information, contained in the AQAA, SOP and SUG, was found to be a true reflection of how the Providers meet this outcome. Discussions with the registered manager identified that people wanting to come in to the home receive a comprehensive needs assessment before admission. This is carried out by staff with skill and sensitivity. Staff at the home are highly efficient in obtaining a summary of any assessment undertaken through care management arrangements, and insist on receiving a copy of the care plan before admission. These assessments were observed in individual care plans during the inspection visit. We also spoke with a visitor who told us that she had been to have a look at the home prior to her relative coming in and went away with a very good impression - thinking “this is the place for my relative – I don’t need to look any further”. Before agreeing admission the staff carefully consider the needs assessment for each individual prospective person and the capacity of the home to meet their needs. People and their families are given the opportunity to spend time in the home. During the inspection visit we were invited to sit in on a meeting between the registered manager, clinical manager, a unit manager and a nurse. This meeting was being held to discuss the prospective admission of a person from another area who has a multitude of needs. Scotia Heights DS0000064684.V372287.R01.S.doc Version 5.2 Page 12 This meeting demonstrated the depth of information needed in order for the staff to be able to make a decision on whether to admit someone to the home. Staff also shared their specific knowledge about the person’s needs and what the home would have to put into place in order to be able to meet these complex needs. Each of the staff member’s contribution, suggestions and thoughts were taken seriously and considered. The staff members had already met with the person to discuss their requirements, needs and preferences. At the end of the meeting it was decided that more information was required before a final decision could be made and a place could be offered. The conclusion was that a meeting was to be arranged between the staff at the home (responsible for admission) and the people who knew this lady and her needs including her social worker. The Manager explained to us that these staff meetings are not unusual and take place when staff need to discuss prospective admission to the home. He also went on to say, “It is very important for everyone involved that we get the admission process right.” Scotia Heights DS0000064684.V372287.R01.S.doc Version 5.2 Page 13 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6,7 and 9 were assessed. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Individuals are involved in decisions about their lives, and play an active role in planning the care and support they receive. EVIDENCE: In their AQAA the Providers say that each person living in the home has their care plan in their files and that it is reviewed on a regular basis. There is also a multidisciplinary record kept in the file as well as any preferred activities, this information is maximised when providing and planning care. The SOP says – “We work with residents and relevant parties to establish an individual and holistic plan of care, identifying views, wishes and choices.” Scotia Heights DS0000064684.V372287.R01.S.doc Version 5.2 Page 14 In their SUG the Providers tell people living in the home that – “with your involvement we will devise a plan of care with details about how your care needs and lifestyle choices will be met. With your permission, your family and friends may also be involved in the planning of your care. Your care document is available to you at any time.” It also tells people –“We will promote informed positive risk-taking ensuring there is a workable balance between risk, your safety and the safety of others.” During the inspection process the above information, contained in the AQAA, SOP and SUG was found to be a true reflection of how the Providers meet this outcome. We looked at a number of care plans and spoke to people who live in the home and some visitors. The care plans are person centred with individual choices and preferences being at the core of the plan. All activities of daily life reflect the individual’s personal choices throughout. People and their relatives told us that they are involved in the reviews of their care plans. A visitor told us, “I look through my husband’s care plan monthly to see if there are any changes and discuss these with the nurse.” The care plans contain risk assessments which help the person take calculated risks in order to continue to lead purposeful and fulfilling lives as independently as possible. The Staff are fully committed in supporting individuals and discussions with staff members identified that they are very aware of the importance of this when planning care with people. Scotia Heights DS0000064684.V372287.R01.S.doc Version 5.2 Page 15 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): All the standards for this outcome were assessed. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People who live at this home are able to make choices about their life style, and are supported to develop their life skills. Social, educational, cultural and recreational activities meet people’s expectations. EVIDENCE: It is stated in the AQQA that in the last 12 months the Providers have “established very positive relations with local organisations benefiting service users, including Headway, Stoke on Trent College and the deaf club.” The home has also acquired a mini-bus with adapted seating to provide greater flexibilities for trips and excursions.” Scotia Heights DS0000064684.V372287.R01.S.doc Version 5.2 Page 16 The SOP says – “The contribution that friends and relatives may make to enhance the service users stay at the home is valued, and every effort is made to ensure continuity of their contributions. An open and flexible approach is adopted towards visiting and privacy is provided as required for visitors. A telephone is available in each bedroom, computers with internet facilities, games and hairdressing are provided. Service users are assisted in the development and maintenance of links with the community. Opportunities and practical encouragement is provided to access and participate in programmes of education, life skill development, and where feasible employment. A full time skills co-ordinator is available to assist service users in engaging in social activities, the pursuit of hobbies and other interests.” The SUG tells people who live in the home that, “we will assist you to maintain links with the community. We provide appropriate transport, which is cost effective to the individual service user. The life skills co-ordinator can arrange complementary therapies and a list of charges is available on request.” During the inspection process the above information, contained in the AQAA, SOP and SUG was found to be a true reflection of how the Providers meet this outcome. We spoke with one of the people who lives at the home and who organises some of the trips out and events. She is also in charge of the in-house magazine entitled – “Scotia Heights Adventures.” She is a very vibrant individual who obviously enjoys organising and getting involved. Although this person is receiving continuous Oxygen therapy, this does not prevent her involvement in activities and events. The home facilitates involvement for this person and all other people wherever possible. The staff know and record the preferred communication style of the people and use new and innovative methods that enable the person to fully participate. We observed a person, nursed in bed, completely unable to move, who communicates through use of a specially designed communication screen to be used by eye movement. Staff have worked with the person to enable him to spell out words and communicate. His wife, who was visiting at the time, is extremely pleased with the home for enabling and facilitating this. The home organises many fund raising events, not just for the ‘Residents’ Fund’ but also for other charities. People who live in the home become totally involved in these events, often taking part in the raising of money and organising themselves. Trips out have included trips to Blackpool, Llandudno, the theatre, (to see various plays), Trentham Gardens and Sailing on Rudyard Lake. Scotia Heights DS0000064684.V372287.R01.S.doc Version 5.2 Page 17 Birthdays are always celebrated and the representative from the Residents’ Forum told us that his son had recently celebrated his 21st birthday and the home had, “pulled all the stops out” for his party. He said that the home had provided a place where all of his family members could come together and celebrate which his son had enjoyed immensely. We held a discussion with the representative from the Residents’ Forum and he explained how regular meetings are held, every 3 months. Minutes from these meetings are taken and then, “I take these to David – the manager and talk to him about what we would like.” He told us –“activities are very important for our loved ones,” and, “as a result of these meetings the activities have improved.” “There is now Occupational Therapy, music therapy and access to the internet.” The activities/skills co-ordinator was praised and spoken of very highly by staff, relatives and some of the people who live at the home. Unfortunately we were told that she had recently left her job and that this role is currently being advertised. We noted that therapeutic activities are geared around individual needs, preferences and abilities. People are assessed for this and they and their families are spoken to about what they would like to do and achieve. Documentation included – “A has been round to Dimensions for a pint of shandy.” “We went for a walk around the museum.” “J has been to Tunstall to do some shopping.” “Called in on M this evening and read her 2 chapters of her book.” “Spent two and a half hours with N, we played Connect 4 and Frustration.” We spoke with people who live at the home and their representatives about the meals. Everyone spoke highly of the food served and we saw the lunchtime meals. These looked appetising and were well presented. We spoke with the Catering Manager who explained how the menus are adapted to meet the needs and preferences of the people who live at the home. She has a list of the likes, dislikes, and preferences of people including any special diets. The catering manager explained how she regularly carries out a ‘residents’ survey’ (usually done weekly) to find out what people think of the dishes served. Comments such as “D did not like mushroom stroganoff on Saturday” were seen. We saw the food survey done on 18/8/08. Scotia Heights DS0000064684.V372287.R01.S.doc Version 5.2 Page 18 Environmental Health has inspected the kitchen and there is a new food management system in place. Meals are sent up to the units in hot trolleys (one for each unit). The cleaning schedule was seen in place for the kitchen. Each unit also has a satellite kitchen where breakfasts and snacks are prepared. The care plans also reflect food – likes and dislikes, and level of assistance required, if any. Scotia Heights DS0000064684.V372287.R01.S.doc Version 5.2 Page 19 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18,19 and 20 were assessed. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. EVIDENCE: The AQAA specifies that the home provide individual care plans and information required to meet each person’s needs. They say that they have trained staff and a team to look at activities and offer a physiotherapy suite. Their evidence for this is that they have care records updated daily, medication administration records, access to G P and referrals to other agencies when required. Personal preferences are identified. In their SOP the Providers say that they offer – “an holistic approach to the delivery of care” and “care plans are compiled and maintained to reflect the individuality of every resident. Care is delivered using recognised models of Scotia Heights DS0000064684.V372287.R01.S.doc Version 5.2 Page 20 nursing to maximise independence and provide a therapeutic relationship between carer and resident. Residents are encouraged to be involved with their personal care plans.” In their SUG the Providers tell the people who live at the home – “we will work with you to establish an individual and holistic plan of care, which identifies your views, wishes and choices, thus ensuring that you are involved in the delivery and review of care throughout your stay at Scotia Heights.” During the inspection process the above information, contained in the AQAA, SOP and SUG was found to be a true reflection of how the Providers meet this outcome. We spoke with the relative of a person who is accommodated in the home and who is totally dependant on the staff for meeting all of his needs. She told us that she is very pleased with how the staff care for her relative and said, “We have come into a 5 star hotel”. She also said that the difference in his care from receiving hospital care to his care at the home is, “unbelievable.” She went on to say that her relative has made, “unbelievable progress” since coming to the home. “He had a pressure sore when he came in and the staff healed this over the weeks following his admission to the home.” She also told us that, although her relative is nursed on a special alternating pressure mattress – “the staff still go and change his position 4 hourly”. We looked at this person’s care plan and this was found to be a comprehensive plan of how his complex nursing and care needs are met. We observed that care was being delivered as per his plan. We looked at other care plans and found that the general consistency of these is very good. Plans are person centred and offer personal support. The home ensures that healthcare needs are met – both general and psychological. Outside professionals such as GPs, Chiropodists, Opticians, and Dentist are accessed as and when required. Also a number of people in the home require emotional support and we saw examples of how this is delivered. We observed a unit manager dealing very sensitively with a person who has quite intense emotional needs. She did this at the same time as helping us to look at care plans and medication. The way she dealt with this person is commendable. The spokesperson for the ‘Residents’ Forum’ said that the home is very good in the following areas – “Drug administration, staff skill mix and quality of qualified nursing staff.” Scotia Heights DS0000064684.V372287.R01.S.doc Version 5.2 Page 21 We looked at the medication process on one of the units and found this to be in keeping with requirements and with the medication policy of the home. In their SUG Providers tell people who live in the home – “We encourage and support you to keep and administer your own medication if you are able to do so. Individual lockable storage facilities will be provided for this purpose. Staff will carry out a self-medication assessment with you and this will be included in your care profile.” Scotia Heights DS0000064684.V372287.R01.S.doc Version 5.2 Page 22 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): We assessed both standards 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live at this home are able to express their concerns, and have access to a robust, effective complaints procedure. The policies and procedures adopted by the home help to keep people safe. EVIDENCE: The AQAA indicates that staff are trained to deal with the protection of vulnerable adults, (POVA), Abuse Awareness, and Whistle Blowing. It appears that management have reviewed and modified their policies to accommodate the learning from complaints after discussion in the Quality Committee Meeting, and that the outcomes were swiftly actioned. The evidence for this is from the way the home managed a complaint, which was received in May 08 in respect of the quality of respite care. It is also emphasised that the staff and people who live in the home are made aware of the complaints procedure and that staff are trained to recognise and report abuse and take action. In their SOP the Providers tell us – “Scotia Heights has a zero tolerance policy concerning adult abuse. All staff are made aware of this policy. Scotia Heights DS0000064684.V372287.R01.S.doc Version 5.2 Page 23 All allegations of abuse, whether physical, financial, verbal, emotional, sexual or insidious, and from whatever source, are fully investigated and reported in line with Company policy”. The SOP also contains the Complaints Procedure, which is also displayed throughout the home. The SUG also contains a copy of the Complaints Procedure. During the inspection process the above information, contained in the AQAA, SOP and SUG was found to be a true reflection of how the Providers meet this outcome. When we spoke to people in the home including visitors, they told us that they would feel free to raise any concerns and would know who to go to with them. The spokesperson for the ‘Residents’ Forum’ told us that the manager had dealt with concerns very well in the past. He also said that the ‘Residents’ Forum’ meetings are good ways of addressing any concerns people and their relatives might have and he gave examples of how the manager had made improvements as a result of these concerns. We have attended 3 safeguarding referral meetings with Social Services in relation to this home since the last inspection and are aware of 1 other taking place. The manager and staff at the home have co-operated fully with the safeguarding procedures on each occasion. Social Services raised concerns in the past that the home has not always adhered strictly to the local Safeguarding Procedure. Following one of these referrals, we looked at the home’s Safeguarding procedure. It was somewhat misleading for staff and did not make it clear which pathway to follow for making referrals. We discussed this with the clinical manger at the time and the home have since addressed their procedure. This now appears to be working better for staff. We spoke to some staff members about this procedure and they were all well aware of what their actions would be in the situation. All staff delivering care undergo training and instruction in the Protection Of Vulnerable Adults. At the time of the inspection visit one of the unit managers was delivering a staff training session in POVA. Scotia Heights DS0000064684.V372287.R01.S.doc Version 5.2 Page 24 Scotia Heights DS0000064684.V372287.R01.S.doc Version 5.2 Page 25 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 and 30 were assessed. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enables people to live in a safe, well-maintained and comfortable environment, which encourages independence. EVIDENCE: According to the AQAA, in relation to the national no smoking policy in public places, the home has provided a dedicated smoke room for the users of the service. There appears to be plans in place to improve the facilities and the environment to accommodate a games room and an Occupational Therapy room. Scotia Heights DS0000064684.V372287.R01.S.doc Version 5.2 Page 26 In their SOP the Providers say – “There are 10 individual bedrooms on each unit all with full ensuite facilities.” In the SUG the Providers tell the people who live at the home – “each room has full ensuite facilities and may be decorated and furnished to your individual choice, subject to fire and safety regulations. Towels and bed linen are provided in each room. You are welcome to bring in your own possessions. All soft furnishing and seating must meet current fire regulations before being brought to Scotia Heights. The home manager will provide you with further advice about this. In addition to the en-suite facilities, bathrooms with specialist equipment are situated on each floor. These are available for use by all residents. Communal rooms are available for you when you wish to socialise with others, or participate in activities or enjoy a different environment from your own room. Wheelchair access is available to both internal and external facilities of the building. Access to the first floor is via the lift situated next to the main entrance and reception.” During the inspection process the above information, contained in the AQAA, SOP and SUG was found to be a true reflection of how the Providers meet this outcome. The home is new and purpose built and is divided into 6 small units and as such, is designed to provide small group or ‘cluster’ living where people can enjoy maximum their independence in a discrete, non-institutional environment. The home has a wide range of up to date specialist equipment and adaptations to meet the individual needs of people who live there. The environment is fully able to meet the changing needs of people, along with their cultural and specialist care needs. It is fully accessible throughout to people with physical disabilities and adaptations and specialist equipment are designed to fit within the homely environment. People who live at the home can be involved in cooking (in the satellite kitchens on each unit) and also have their own laundry where they can wash, dry and iron their own clothes if they choose to do so. The bathrooms are homely and include aids and adaptations to meet the needs of the people living there. There are sufficient toilets to enable immediate access. The home is very clean and well presented and staff adhere stringently to infection control guidelines. Scotia Heights DS0000064684.V372287.R01.S.doc Version 5.2 Page 27 People told us –“The home is always spotless, there are always cleaners around and the rooms are cleaned daily.” Another person said –“my relative likes to sit at the table in the lounge in a certain position in his wheelchair, so that he can see what’s going on. So, because his chair would not fit underneath the table properly, they altered the table so that it would! Nothing is too much trouble for them.” The Clinical Manager told us – “The rooms are adapted to suit the individual needs of each person.” Scotia Heights DS0000064684.V372287.R01.S.doc Version 5.2 Page 28 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32,34 and 35 were assessed. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to support the people who live in the home and to support the smooth running of the home. EVIDENCE: From the AQAA it appears that the home does well in the following areas, recruitment, scored interviews, provision of job descriptions, induction and training, provision of registered nurses on duty, high clinical staffing levels, staff taking relevant national vocational qualifications, (NVQ) courses including the Domestic. In the SOP the management and staffing structure is documented and explains the recruitment, induction, training, supervision, experience and skills of staff in the home. Scotia Heights DS0000064684.V372287.R01.S.doc Version 5.2 Page 29 The SUG goes into more detail about the Provider, manager and nurses employed at the home. People are told – “A member of the qualified staff will act as your named nurse. That person will be responsible for ensuring that your individual care needs are planned and met. In addition you will also have a key worker who will assist you with any other personalised specific tasks such as letter writing, shopping, and accompanying you to any appointments you may have. Your key worker will be responsible for ensuring that other members of the acre team are aware of your requirements when they themselves are not on duty.” During the inspection process the above information, contained in the AQAA, SOP and SUG was found to be a true reflection of how the Providers meet this outcome. The people who live in the home told us that the staff are, “all very caring and always there for you,” and, “the level of staff is good and staff skill mix is good.” We spoke to some staff members and one said –“I couldn’t believe the numbers of staff on for each unit when I came here. It’s great – you can actually get to do your job properly and still have time to spend with the residents!” This nurse also told us that she had received, “excellent induction training.” We observed good staff interaction with the people who live at the home. Staff are very aware of the individual needs of people and offer sensitive support. One of the unit managers was observed interacting very well with a person who had obvious emotional and psychological needs. Her sensitive, patient and professional approach in difficult circumstances should be commended. We looked at a number of staff files and examined the staff recruitment procedure. We spoke with the registered and clinical managers about this. The home is highly selective, with the recruitment of the right person for the job being more important than the filling of a vacancy. Staff undergo stringent checks including Criminal Records Bureau (CRB) and Protection Of Vulnerable Adults (POVA). Also each staff member has to provide an employment history, evidence of their qualifications and two written references. The manager stated, “We don’t use agency staff because they would not know the people in the home and would be unaware of individual needs.” The home has a staff training and development programme aimed specifically at understanding the needs of the people accommodated in the home. Examination of staff training records and discussions with staff members Scotia Heights DS0000064684.V372287.R01.S.doc Version 5.2 Page 30 identified that the staff team has a balance of all the skills, knowledge and experience to meet people’s needs. The home now has a full time training manager to oversee the staff-training programme. We spoke with him, and he is very enthusiastic about his new role. Through observation of care practices, discussions with staff, people who live in the home and their representatives, we identified that staff demonstrate a thorough understanding of the particular needs of individuals, and can deliver highly effective person centred care. Scotia Heights DS0000064684.V372287.R01.S.doc Version 5.2 Page 31 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37,39 and 42 were assessed. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect and effective quality assurance systems are developed by a qualified, competent manager. EVIDENCE: It appears that the home is well managed from the information contained in the AQAA. A range of system polices and procedures are in place. There appears to be regular meetings with management and staff and minutes Scotia Heights DS0000064684.V372287.R01.S.doc Version 5.2 Page 32 kept. There is also a ‘Relative’s Forum’ to raise any concerns and to add communication. People are involved with the management of the home. There are 3 nurses who have undertaken training to NVQ level 3 in mentorship at Keele University. The SOP says – “Feedback, views and opinions from service users and relevant parties is welcome. Facilities are available for an informal monthly meeting for residents and relatives to encourage open discussion about the home and provision of service. Managers and care staff only attend this meeting at the invitation of residents and relatives. Managers and qualified nursing staff are always available for service users and relatives to discuss delivery of care on a one to one basis. Questionnaires are sent to residents and relatives twice per year to seek their views about the home and service delivery. Responses and feedback are given to managers and acted upon appropriately.” The SUG tells people – “Scotia Heights has an ongoing programme of Quality Assurance, which is designed to measure, evaluate and determine the effectiveness of all aspects of our service to you. This includes – The monitoring of and response to complaints. Internal and external audits of care and service delivery. Your views (through service users’ forum meetings/questionnaires). Views from your relatives or advocates and visiting professionals. The Responsible Individual, on a monthly basis, reviews the home’s effectiveness in its provision of a quality service and reports findings to the board of directors.” During the inspection process the above information, contained in the AQAA, SOP and SUG was found to be a true reflection of how the Providers meet this outcome. The registered manager (David) has the required qualifications and experience and is highly competent to run the home. David is actively involved in the marketing of the home and has sound knowledge of the organisation’s strategic and financial planning systems and how the operational or business plan for the home ‘fits’ with these. David told us that the Providers are, “an excellent Company to work for”. Mark – the Clinical Manager, supports David. Both managers work well together, regularly meet (daily) and complement each other well. Mark is more directly involved with patient care, although not hands on. He visits all of the units daily, communicating with the unit managers and speaking to people who live on the units and their visitors. It is apparent that both Mark and David have a great deal of knowledge about the people who live in the home including their needs and their characteristics. Scotia Heights DS0000064684.V372287.R01.S.doc Version 5.2 Page 33 People who live in the home told us that the unit managers, clinical manager and registered manager are all supportive and approachable. A visitor said – “ Oh I just go and have a chat to them if I’m not sure about anything – they’re all very good!” The ethos of the home is open and transparent. The views of both people who use the service and staff are listened to, and valued. The spokesperson for the ‘Residents’ Forum’ told us that following each meeting he takes the minutes to David (registered manager) and discusses these with him. He said that David always listens to their suggestions and, if there are good reasons for wanting changes in the home or purchasing of equipment he will always try and provide these. As a result of these meetings, the manager has provided music therapy, occupational therapy, 2 in-house physiotherapists and 2 minibuses, as well as other things. The next proposal is for a new conservatory for the people who live at the home to enjoy. The manager and clinical manager also complete regular audits such as medication, care planning, clinical audits and audits in health and safety. The manager also told us that, whenever possible, he likes to involve people who live in at the home in staff recruitment interviews. ‘Client Satisfaction Surveys’ were seen and these contained comments such as, “Mrs B would like more activities for J,” (she had ticked everything else as “excellent). The other surveys read “good” or “excellent”. The manager informed us that the home had just been awarded as ‘The preferred providers to the Multiple Sclerosis Society’. He said that this process of auditing had taken 12 months and had been a very comprehensive audit. The home has also achieved the, ‘Top 5 Dignity and Care Awards’ for StokeOn-Trent. The home is well recognised by Keele University and as such, sends Student Nurses on placements. We spoke with one of these student nurses and she explained that she had just completed her placement here. She said – “I have thoroughly enjoyed it. The staff and managers have all been very helpful. I have learned a lot here and will miss it.” The home have prepared themselves to be able to take Student Nurses on placements by training 7 of its nurses in “Mentorship”. The home has a Health and Safety policy statement in place. Scotia Heights DS0000064684.V372287.R01.S.doc Version 5.2 Page 34 The SUG asks the people who live in the home to observe the health and safety notices in respect of – “Fire Precautions, Fire Procedure, Smoking, Alcohol and Electrical Equipment” All staff undergo mandatory Health and Safety training in moving and handling, infection control, fire safety (including fire drills) and COSHH. David (the manager) is an advanced Health and Safety trainer. We saw records to identify that staff receive this training regularly and discussions with staff confirmed this. We also saw records to confirm that equipment used in the home is regularly tested and serviced as required. All the working practices in the home are safe and there are good monitoring systems in place. Scotia Heights DS0000064684.V372287.R01.S.doc Version 5.2 Page 35 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 4 2 4 3 4 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 4 25 x 26 x 27 x 28 x 29 x 30 4 STAFFING Standard No Score 31 x 32 4 33 x 34 4 35 4 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 x 4 x LIFESTYLES Standard No Score 11 x 12 4 13 4 14 x 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 4 x 4 x 4 x x 4 x Scotia Heights DS0000064684.V372287.R01.S.doc Version 5.2 Page 36 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. Standard Regulation Requirement 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. Refer to Standard Good Practice Recommendations Scotia Heights DS0000064684.V372287.R01.S.doc Version 5.2 Page 37 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Scotia Heights DS0000064684.V372287.R01.S.doc Version 5.2 Page 38 - 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. 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