Inspection on 16/08/07 for Selborne Mews

This inspection was carried out on 16th August 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Selborne Mews 20/02/07

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Polesworth Group 68 Long Street

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Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Selborne Mews 36-37 South Road Smethwick West Midlands B67 7BU Lead Inspector Mandy Beck Unannounced Inspection 16 and 20 August 2007 09:00 th th Selborne Mews DS0000067092.V342723.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 Selborne Mews DS0000067092.V342723.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. Selborne Mews DS0000067092.V342723.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Selborne Mews Address 36-37 South Road Smethwick West Midlands B67 7BU 0121 555 5615 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) Selborne Care Limited Mr Kevin Taylor Care Home 20 Category(ies) of Learning disability (20) registration, with number of places Selborne Mews DS0000067092.V342723.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide personal care (inculding nursing) and accommocation for service users of both sexes whose primary care needs on admission to the home within the following categories: Learning Disability (LD) 20 The maximum number of service users to be accommodated is 20. 2. Date of last inspection 20th February 2007 Brief Description of the Service: Selborne Mews provides care for up to 20 service users in three separate units. Fontwell, Exeter and Hexam. The home is unique in its design and enables service users to receive twentyfour hour care and attention in the comfort of their own apartments. In each apartment service users benefit from a kitchen with a dining area, bathroom, bedroom and a living area. There are three two bedroomed apartments for those service users who wish to share accommodation. The home is situated close to Smethwick town centre and is accessible by bus and train. The home’s Statement of Purpose says that the service aims to work in partnership with the public sector and identified stakeholders to provide highly specialised and individual packages of care based on individual assessments and care programmes to enhance the lives and independence of the residents of Selborne Mews. Fees for residency vary from £1600 to £2895 per week depending upon individual care needs of service users. This charge does not include extra services such as hairdressing costs, newspapers and magazines and telephone calls if service users choose to have their own private telephone line installed. Selborne Mews DS0000067092.V342723.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit to the home carried out over two days by one inspector. A variety of methods have been used to reach the judgements in this report. The home has given us information about the service they provide in their Annual Quality Assurance Assessment (AQAA) we have included some of this information in the report. Service user files were also looked at in depth as part of our case tracking process. This process allows to make decisions about whether the service is meeting the needs of service users. Staff files were examined to ensure that the home continues to recruit staff members safely and that all appropriate security checks have been completed. Some of the service users have also completed a service user questionnaire we sent to them. Other service users were spoken with during the course of the inspection. Some of there comments have been included in this report. The inspector would like to thank everyone at Selborne Mews for their hospitality throughout the inspection. What the service does well: The home has good assessment processes in place. This means that no service user will move into the home without having their needs assessed in full. The manager can also be sure that the service is able to meet those needs. People who live at this home can feel confident that they will supported in leading as independent life as possible. They can be sure that their health care needs will be met and regularly monitored throughout their stay at Selborne Mews. Accommodation is well presented, each service user has their own self contained apartment that is fully furnished and provides a relaxing place for service users to live. Staff are recruited and selected in a manner that safeguards service users. All new staff receive an induction that introduces them to the home and the service users living in it. Staff feel supported by the manager and are confident that he will support them. Selborne Mews DS0000067092.V342723.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Selborne Mews DS0000067092.V342723.R01.S.doc Version 5.2 Page 7 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 Selborne Mews DS0000067092.V342723.R01.S.doc Version 5.2 Page 8 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): 2,3,4 Quality in this outcome area is good. People who may use this service can feel confident that the home will assess their needs in full before they move in. This judgement has been made using available evidence including a visit to this service. EVIDENCE: New service users are only admitted to the home once a comprehensive assessment of their needs has taken place. Two service users files were seen on this occasion as part of our case tracking process. Both of these files contained detailed assessments from the home and service users social workers. Assessments are used to form the basis for risk assessment and care planning, they are also completed with the service user. This gives them the opportunity to be involved in the way their care is planned this includes any restrictions of freedom and choice that may be necessary. Prospective service users can spend time at the home before they agree to move in. This gives them the opportunity to meet other service users and to make a decision about whether the home is right for them. The amount of time service users spend at the home before they move in is tailored to meet individuals needs. Selborne Mews DS0000067092.V342723.R01.S.doc Version 5.2 Page 9 Since the last inspection the home has now introduced terms and conditions of residency for service users. This gives service users clear guidance of their rights and responsibilities whilst living at Selborne Mews. Selborne Mews DS0000067092.V342723.R01.S.doc Version 5.2 Page 10 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): 6,7,9 Quality in this outcome area is good People who live at this home are encouraged to be as independent as possible. Restrictions on freedom are managed sensibly and in the best interests of the people who live there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Every service user has their own individual plan that details all of their care needs. The plan is drawn up with their involvement and is agreed by them. It was pleasing to see that there have been improvements to this process. The home is now working toward a more person centred approach to planning care. This was seen when we looked at service user’s files. There are good systems in place for dealing with limitations on freedom, in accordance with the Care Programme Approach and Probation Service. This means that both staff and service users are aware of the restrictions placed upon them and they are managed sensitively. Selborne Mews DS0000067092.V342723.R01.S.doc Version 5.2 Page 11 Staff encourage all of the service users to make decisions about their lives, they do this by offering them choice and giving them information needed to make decisions. Some service users manage their own finances and the home supports them in doing so. The home has very good systems in place to make sure that all monies are kept safe and secure. Service users have their own individual risk assessment that enables him or her to live as independently as possible. The manager has introduced a new system of risk assessment and has linked it to the evaluation of service users care. All risk assessments show the potential risk, such as violence to others, self harm and misuse of substances and the methods of risk reduction. One service user said “I would like to get better, learn to cope on my own and go out on my own, the staff are helping me to do this”. Selborne Mews DS0000067092.V342723.R01.S.doc Version 5.2 Page 12 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): 12,13,15,16,17 Quality in this outcome area is good People living at this home are supported to take part in activities and to maintain their relationships with family and friends. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Activity plans were found to be in place on both service user files. One of the files seen did not have a completed activity form however there was other evidence to show that he has taken part in activities both in the home and the community. Since the last inspection the manager has reviewed the shift times that staff work. Staff are now staying on duty until 10pm this helps service users stay out later and enjoy evening activities. There are good opportunities for all service users to be part of the local community. Several of the service users attend day centres during the week, this gives them the opportunity to meet with friends and spend time away from the home. Other service users spend their time working in paid Selborne Mews DS0000067092.V342723.R01.S.doc Version 5.2 Page 13 employment or visiting their families and in some cases staying with them for weekend leave. During service users meetings there is an opportunity to put suggestions forward for trips, holidays and other outings service users are interested in. All of the service users are invited to go on holiday at least once a year, the home will pay for this but service users will have to provide their own spending money. Service users are encouraged to sit with their key worker on a weekly basis and plan their shopping and menu for the week. Each service user has £4 a day to spend on food. Staff will help each service user prepare and cook their meals as outlined in their individual care plans. The amount of assistance service users require varies from person to person. The home routinely completes risk assessments for each service users that looks specifically at their nutritional intake. Service users are supported to make choices about their diet and it was good to see that the dietician had been asked to come and advise one service user on their dietary intake. This will give the service user the opportunity to discuss their diet and give them the information they will need to make choices about healthy eating and dietary recommendations. Selborne Mews DS0000067092.V342723.R01.S.doc Version 5.2 Page 14 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): 18,19,20 Quality in this outcome area is good People who live here can feel confident that their healthcare needs will be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service user’s personal health care needs are appropriately managed. Files we looked at showed that people receive intervention from professionals including general practitioners and psychiatrists. Care plans for the management of psychological needs are in place along with other specific medical conditions. We looked at one care plan for the management of epilepsy, it was comprehensive and gave staff clear instructions on what to do when a seizure occurs. Another care plan addressed a specific mental health issue, the plan listed relapse triggers and actions for staff to take to ensure that the service user did not become too distressed. Care plans also included the individual preferences of service users when receiving personal care from staff, such as a male of female worker to assist them with personal care. Other documentation in relation to healthcare management viewed includes Waterlow pressure sore risk assessments and manual handling reviews. Selborne Mews DS0000067092.V342723.R01.S.doc Version 5.2 Page 15 Staff continue to respect the privacy and dignity of service users which can be difficult at times given the intense support some service users need. The home has also privately procured the services of a consultant psychiatrist to meet the needs of one service users because of the nature of their specialist needs. Qualified nurses and team leaders are responsible for administering medication. There are good systems in place for the ordering, receipt and disposal of medication. There are a couple of minor improvements that could be made to the process that would improve practice further, such as recording on the MAR sheet the amount of medication received from the pharmacy and signing it especially handwritten entries. Staff should also record the temperature of the medication storage room as a matter of good practice. This will provide a clear record that medicines are being kept within the recommended temperature for safe storage. There have been improvements since the last inspection, service users now have detailed “as required” care plans for any medication that needs to be administered in this way. This means that staff are clear about the circumstances in which “as required” medication should be given to service users. Selborne Mews DS0000067092.V342723.R01.S.doc Version 5.2 Page 16 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): 22,23 Quality in this outcome area is good People living at this home can feel assured that their views will be listened to and acted on. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has received no complaints at all since the last inspection. All of the service users, except one, who completed the surveys for the CSCI indicated they were aware of who to talk to if they were unhappy about anything. The home has a clear policy and procedure to follow in the event of any concerns being raised. All service users are encouraged to raise concerns during residents meetings and privately with their key worker if they choose to do so. All of the staff have now had training in adult protection, this included recognising the signs of abuse, the different forms of abuse and where to go to get help when alleged abuse has taken place. Since the last inspection the manager has worked well with the Adult Protection Team and informs them on a monthly basis of incidents that have taken place in the home. No service users currently manage their own finances. Advocates, including appointeeship units, undertake responsibility in this area. Service users do manage their own personal allowance, staff will assist them in collecting it where necessary. Selborne Mews DS0000067092.V342723.R01.S.doc Version 5.2 Page 17 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): 24,30 Quality in this outcome area is good The home is well maintained, clean and hygienic. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A partial tour of the building was undertaken, it was pleasing to see that home is well maintained and that service users do benefit from having their own self contained apartments. All of the apartments have a kitchen so that service users can participate in preparing and cooking their own meals, a bathroom to maintain their privacy and their own individual living spaces. There are three two bedroomed apartments in total for those service users who choose to share accommodation. Since the last inspection the last unit, Hexham has been registered with the CSCI and the home is now able to offer placements for more service users. There is also a small communal meeting room where service users can relax with others and take part in leisure activity should they choose to do so. Service users said “it is very nice and tidy” Selborne Mews DS0000067092.V342723.R01.S.doc Version 5.2 Page 18 The courtyard at the back of the home has been improved with the provision of new outdoor furniture. It now offers a more inviting and relaxing place for service users to spend their time in. Maintenance and housekeeping workers have now been employed to ensure that the current standard of maintenance and cleanliness is kept. The manager has spent considerable time trying to address the issue of access to the building for service users. There are new plans in place to improve access to the building for those people who cannot manage the steps. It is planned that a portable ramp will be available for use in the near future. There are individual laundry facilities in each apartment but staff do have a central laundry and sluice to access if needed, improvements have been made that mean service users are protected from the risk of cross infection, such as the production of a cleaning schedule that included the daily disinfection of all mop heads. Since the last inspection staff have benefited from infection control training to improve both their knowledge and skills. Selborne Mews DS0000067092.V342723.R01.S.doc Version 5.2 Page 19 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): 32,34,35 Quality in this outcome area is good People living at the home are supported by competent and qualified staff. There are sufficient staff to meet service users needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are enough members of staff on duty to meet resident’s needs. There is always a trained nurse on duty and support workers who assist them. The majority of service users who live at Selborne Mews require intensive support from nursing and care staff, this is often on a one to one basis, more staff will assist if service users need them. Most of the staff have now completed or are in the process of completing their NVQ level 2 in healthcare. Service users also commented about the staff saying “they are great”, “staff are very helpful, that makes me happy”, “they help me to see my family”, “the carers are very nice”. Some staff files were examined to make sure that the home has all of the required documentation. It was pleasing to see that all records were up to Selborne Mews DS0000067092.V342723.R01.S.doc Version 5.2 Page 20 date, that staff had had the required safety checks before being employed and that they had received an induction when they began working in the home. Each member of staff has their own individual training plan and the organisation has good systems in place to identify when staff are due for updates in training. This ensures that all staff has the required knowledge and skills to care for the service users. All staff have regular supervision, this gives them the opportunity to discuss their progress and to identify any specific training needs they may have. The manager will also complete an annual appraisal for each member of staff once they have been employed for a year. New workers are appointed a mentor who supports them through their induction period. Selborne Mews DS0000067092.V342723.R01.S.doc Version 5.2 Page 21 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): 37,39,42 Quality in this outcome area is good The home is well managed and service users health, welfare and safety is promoted. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager of the home is Mr Kevin Taylor he is a registered mental health nurse (RMN) and has many years of experience both working in a hospital setting and more recently social care. Mr Taylor is a qualified trainer and uses his skills to train staff on a regular basis. During discussions with Mr Taylor it is clear to see that he is enthusiastic about developing the home into a place where service users achieve their goals and aspirations. There is a quality assurance system in place, this includes the regular auditing of the environment, medication, and care planning, and the manager also Selborne Mews DS0000067092.V342723.R01.S.doc Version 5.2 Page 22 audits untoward occurrences, accidents and incidents. This helps identify any trends that may occur and allows the manager to formulate an action plan to reduce any risk to service users. Regular service users meetings are now being held and this gives them an opportunity to discuss how the home is developing and if it is meeting service users needs. There are also plans to develop service user, relative and other professional’s questionnaires in attempt to seek further information on the service the home provides to the people that use it. Safe working practices within the home are a priority and all staff have annual updates or statutory training. This helps to keep their knowledge and skills updated. The manager has a training matrix that identifies when staff training is due so that all staff are assured of a place and do not miss out. Safety certificates for the building are all up to date; the manager indicated this in the AQAA document he completed prior to our visit. Selborne Mews DS0000067092.V342723.R01.S.doc Version 5.2 Page 23 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 X 2 3 3 3 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Selborne Mews DS0000067092.V342723.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No 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. 1 Refer to Standard YA20 Good Practice Recommendations Staff ensure that all handwritten entries on the MAR sheet are signed. The temperature in the medication storage rooms should be recorded to ensure that medicines are stored are safe recommended temperatures. Service users, relatives and visiting professionals views about the service should be sought and included into the Quality assurance system. 2 YA39 Selborne Mews DS0000067092.V342723.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Halesowen Office West Point Mucklow Trading Estate Mucklow Hill Halesowen B62 8DA 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 Selborne Mews DS0000067092.V342723.R01.S.doc Version 5.2 Page 26 - 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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