CARE HOMES FOR OLDER PEOPLE
Selkirk House Church Road Plymstock Plymouth PL9 9BD Lead Inspector
Jane Gurnell Unannounced 30 September 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. Selkirk House D52-D04 S3525 Selkirk House V232635 300905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Selkirk House Address Church Road, Plymstock, Plymouth, Devon, PL9 9BD 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) 01752 492850 01752 480496 Anchor Trust Mrs Carolyn Kendall Care Home 39 Category(ies) of Dementia - over 65 years of age (39), Old age, registration, with number not falling within any other category (39), of places Physical disability over 65 years of age (39) Selkirk House D52-D04 S3525 Selkirk House V232635 300905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 2nd February 2005 Brief Description of the Service: Selkirk House is situated in Plymstock close to local amenities and is one of the Anchor Homes Group of Residential Care Homes for Older Persons. The Home is registered to provide accommodation and personal care for 39 people of both sexes over the age of 65. Service Users may have a varying degree of dementia and/or physical disabilities. The Home does not provide nursing care. Accommodation is offered on the 1st and 2nd floors of a 3 storey building with a shaft lift providing access. The Home offers 35 single rooms all of which have en-suite shower rooms and a kitchen area, and 4 larger apartments, which offer a separate kitchen, lounge and bedroom. The Home has 2 lounge rooms and a large dining room. The Home is attractive and welcoming. The garden offers seating areas and is accessible with ramps and handrails. Residents are encouraged to maintain their gardening interests if they wish. Selkirk House D52-D04 S3525 Selkirk House V232635 300905 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place on 30th September 2005. An additional visit was made on 6th October following a fire at the home. The focus of the first visit was to consult with residents and to review the care planning processes. The second visit was to meet the staff and residents involved in the fire incident, to ensure their welfare and to review the home’s practices relating to emergencies. Mrs Weaver, an Assistant Manager, was present on the first day and Mrs Kendall, the Registered Manager, on the second day: both they and their staff team assisted the inspector throughout both visits. Mrs Shires, Anchor Home’s Area Manager, was present on the second day. The inspector spoke to 27 residents, as well as care, domestic and catering staff and made a tour of the building. The inspector also had the opportunity to speak to the Fire Officer on the day of the fire. What the service does well: What has improved since the last inspection? What they could do better:
Mrs Kendall and her staff team have met all, and exceeded many, of those National Minimum Standards assessed and there are no requirements or recommendations for improvement at this time. Selkirk House D52-D04 S3525 Selkirk House V232635 300905 Stage 4.doc Version 1.40 Page 6 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. Selkirk House D52-D04 S3525 Selkirk House V232635 300905 Stage 4.doc Version 1.40 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 Selkirk House D52-D04 S3525 Selkirk House V232635 300905 Stage 4.doc Version 1.40 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) 3, 5 Thorough and comprehensive systems for admission allow residents and their relatives to be confident that their needs can be met. EVIDENCE: A newly admitted resident described that he and his family had been able to visit Selkirk House before making a decision to move in. A pre-admission assessment had been undertaken to identify the resident’s care needs prior to admission. Selkirk House D52-D04 S3525 Selkirk House V232635 300905 Stage 4.doc Version 1.40 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 10 Residents health, personal and social care needs are being met and residents are treated respectfully. EVIDENCE: Residents described living in the home as “excellent” and said they could not be treated better. Care plans detailed residents’ care needs: these plans were reviewed regularly and, where able, the resident had signed their plans. Additional health care needs were clearly documented as well as the action required from staff to ensure these needs are met. The Registered Manager reviewed all accidents and where patterns, such as frequent falls were identified, additional medical assessment was sought. The District Nurse, Community Mental Health Nurse and the Continence Advisor provided specialist advice. Selkirk House D52-D04 S3525 Selkirk House V232635 300905 Stage 4.doc Version 1.40 Page 10 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15 Residents are encouraged to maintain their independence and lifestyle choices. Meals are nutritious and varied. EVIDENCE: Residents described how they are encouraged and supported to maintain their independence and their interests outside of the home. Care staff facilitate weekly activities and many residents said how much they enjoy these. One resident described the knitting group who are making clothes for Romanian orphans. Another resident described how she was preparing for the open day being held the day after the inspection, by making soft furnishings to sell for fundraising. A wide choice of meals is offered daily: on the day of the inspection there was a choice of 5 main meals at lunchtime. Residents said the meals are “excellent” and described that they had met with the chef at the recent Residents’ Meeting to discuss winter menu planning. Selkirk House D52-D04 S3525 Selkirk House V232635 300905 Stage 4.doc Version 1.40 Page 11 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 Complaints and suggestions from residents, relatives or other visitors to the home are treated seriously. Residents are listened to and issues resolved promptly. EVIDENCE: Residents said that the Registered Manager and staff are very approachable and they are confident that any issues of concern would be listened to and dealt with. The home has received no complaints since the last inspection. A copy of the complaints procedure is available to all residents and visitors to the home and detailed in the Service User Guide. Selkirk House D52-D04 S3525 Selkirk House V232635 300905 Stage 4.doc Version 1.40 Page 12 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, 23, 24, 25, 26 Residents live in a pleasant, well-maintained home that is comfortable and warm and which provides sufficient facilities to meet their needs. EVIDENCE: All communal rooms and bedrooms are pleasantly decorated and furnished and residents said that it is always very clean. Selkirk House was purpose built and provides self-contained accommodation: all rooms offer a kitchen area and an en suite shower room. The garden is very pleasant with plenty of seating. Radiators are covered and hot water temperatures in the bathrooms and bedrooms are controlled reducing the risk of injury to residents from burns and scalds. Selkirk House D52-D04 S3525 Selkirk House V232635 300905 Stage 4.doc Version 1.40 Page 13 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, 30 Residents are cared for by caring and motivated staff in sufficient numbers to meet the needs of those currently living in the home. EVIDENCE: Residents described the staff as very kind and caring and confirmed they responded promptly to requests for assistance. On the first day of the inspection there were 5 members of care staff on duty. Care staff are supported by catering, laundry, domestic and administrative staff. The induction programme for newly appointed staff has been reviewed to meet the National Training Organisation’s specifications. One newly appointed member of staff described how she worked alongside an experienced member of staff through her induction process. Selkirk House D52-D04 S3525 Selkirk House V232635 300905 Stage 4.doc Version 1.40 Page 14 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, 36, 37, 38 Residents live in a well managed home. The Registered Manager and her staff team strive to provide a stimulating, safe environment that respects and protects residents’ rights. EVIDENCE: Residents said that they feel safe and secure in the home and that the home was well managed, with Mrs Kendall, the Registered Manager always available. Resident and staff meetings occur frequently allowing consultation on the dayto-day running of the home and future planning. The Registered Manager and the Assistant Managers provide formal supervision to staff. The Fire Office reported to the inspector that the staff were well trained in fire safety and their prompt actions at the time of the fire saved residents from serious injury. Fire safety training and unannounced fire drill practices were well documented as was fire equipment testing and servicing.
Selkirk House D52-D04 S3525 Selkirk House V232635 300905 Stage 4.doc Version 1.40 Page 15 The kitchen and food storage areas were found to be very clean indicating that regular cleaning takes place. Fridge, freezer and cooked food temperatures were recorded to ensure safety procedures were adhered to. Selkirk House D52-D04 S3525 Selkirk House V232635 300905 Stage 4.doc Version 1.40 Page 16 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 x x 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 x 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 4 15 4
COMPLAINTS AND PROTECTION 4 4 4 x 4 4 3 x STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 4 x x x 3 3 4 Selkirk House D52-D04 S3525 Selkirk House V232635 300905 Stage 4.doc Version 1.40 Page 17 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 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 Selkirk House D52-D04 S3525 Selkirk House V232635 300905 Stage 4.doc Version 1.40 Page 18 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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