Inspection on 14/05/07 for Sewells (6a)

This inspection was carried out on 14th May 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Sewells (6a) 02/08/06

Sewells (6a) 01/12/05

Sewells (6a) 30/08/05

Sewells (6a) 21/01/05

Sewells (6a) 10/08/04

Similar services:

Claremont House

Coopers Mill Ltd

Sun Court Nursing Home

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

15 Bramble Close

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

CARE HOME ADULTS 18-65 Sewells (6a) 6a Sewells Welwyn Garden City Hertfordshire AL8 7AQ Lead Inspector B. Ramkhelawon Unannounced Inspection 14th May 2007 11:00 Sewells (6a) DS0000019519.V339622.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 Sewells (6a) DS0000019519.V339622.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. Sewells (6a) DS0000019519.V339622.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sewells (6a) Address 6a Sewells Welwyn Garden City Hertfordshire AL8 7AQ 01707 395 187 01707 321 344 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) tanners@lifeopportunitiestrust.co.uk www.lifeopportunitiestr Life Opportunities Trust Care Home 7 Category(ies) of Learning disability (7), Learning disability over registration, with number 65 years of age (7), Physical disability (7) of places Sewells (6a) DS0000019519.V339622.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd August 2006 Brief Description of the Service: 6a Sewell is a purpose-built modern style bungalow that was designed to accommodate seven adults with learning and physical disabilities. It is located at the end of a cul-de-sac on a housing estate in Welwyn Garden City. All bedrooms are offered for single occupancy and the home is equipped with appropriate adaptations and equipment to enable staff to meet the needs of people living in the care home. The aim of the home is to enable people to play a part in the day-to-day running of the home, ensuring that they have an input into how they live their lives. Particular regard is paid to the privacy of individuals, integration into the community and ensuring that people have a wide range of activities, experiences and relationships available to them. The current fees charged are between £1,135.31 to £1,228.98 per week. A copy of the ‘Statement of Purpose’, ‘Service User’s Guide’ and most recent CSCI inspection report is available from the care home. Sewells (6a) DS0000019519.V339622.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on the 16th June 2007 by one inspector. Feedback from people living in the care home and staff was received. Care plans, records of medicine administration and management, complaints and compliment records, fire safety, health and safety records, policies and procedures and other relevant documents were examined. Staff files were not examined, as these were not available for inspection due to senior staff being off duty on the day. A tour of the premises was also carried out. At the time of the inspection, there were seven people living in the care home and the majority of them were attending to their day activities outside the home. Three of the people living in the care home were spoken with. What the service does well: What has improved since the last inspection? Care plans were comprehensive and easy to follow as how the needs of individuals were being met. Some of the medication which was previously stored in the laundry room has now be moved to the office. Sewells (6a) DS0000019519.V339622.R01.S.doc Version 5.2 Page 6 To improve the appearance of certain areas in the home new laminated wooden floor has been fitted to the bedroom, which had an offensive odour. And the bathroom has been fitted with new lino flooring. 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. Sewells (6a) DS0000019519.V339622.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 Sewells (6a) DS0000019519.V339622.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): 1-5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Adequate information about the care home is available and included in the ‘Statement of Purpose’ and ‘Service User’s Guide’. Comprehensive assessments have been carried out for each person living in the care home in respect of their needs and aspirations with regular reviews undertaken. Each person has a statement of terms and conditions, which forms part of their individual contract. EVIDENCE: The ‘Statement of Purpose’ and ‘Service User’s Guide’ contained the required information and was available to people living in the home. Comprehensive assessments of needs for each person were carried out. The home has procedures for facilitating new people moving in, to start with a ‘trial period’ so that further assessments can be carried out to ensure that the home can meet their needs, and to empower them to make an informed choice whether Sewells is the right home for them. Each person was issued with a contract of tenancy that outlined the residency agreement between the individual and the service. Sewells (6a) DS0000019519.V339622.R01.S.doc Version 5.2 Page 9 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- 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans were detailed and included information on all assessed health care needs; social needs and risk assessments so that care could be provided to meet theses needs. People were supported to make decisions about their lives and participated as fully as possible in all aspects of life in the home and in the community. Service users can be assured that confidentiality is respected and safeguarded and records are securely stored. EVIDENCE: Care plans examined showed that people living in the care home had their assessed needs and aspirations identified and were being met. These were reviewed regularly and reflected individual’s changing needs. Each person has Sewells (6a) DS0000019519.V339622.R01.S.doc Version 5.2 Page 10 an annual ‘whole life’ review which was ‘person centred’. A weekly individual activity programme was devised and included attending day centres and other community facilities. People were encouraged to take part in decision-making and to be involved in the domestic chores of the home. Policies and procedures in relation to confidentiality were in place. Records relating to the people living in the home were securely stored. A key worker system allowed staff to work on a one to one basis and contribute to individual’s care plan. Sewells (6a) DS0000019519.V339622.R01.S.doc Version 5.2 Page 11 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): 11-17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the care home were encouraged and enabled to make choices in relation to food, clothes and activities to optimise their abilities in developing their skills. They were also encouraged and supported to pursue social and leisure activities as stated in their individual care plan. EVIDENCE: Individual’s personal development was promoted by engaging in planned day care, social and leisure activities. Most of the people living in the care home attended a day centre for part of the week. They also have a yearly holiday but this was not planned yet. Sewells (6a) DS0000019519.V339622.R01.S.doc Version 5.2 Page 12 People were encouraged to maintain contact with their relatives and those who are important to them. The menu was planned with people living in the home, taking into consideration individual likes and dislikes. The home has a four-week rolling seasonal menu, which appeared well balanced. Sewells (6a) DS0000019519.V339622.R01.S.doc Version 5.2 Page 13 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): 18-20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessment and reviews were completed, and changes of needs are reflected in individuals care plans so that needs can be met appropriately. Peoples health care needs are being met with some good examples of effective interagency working. The good management and administration of medicines protect people that use the service. EVIDENCE: People’s personal and health care was being provided as set out in their care plans. The progress notes indicated that identified needs were being met and kept under review. Changes in any needs were also reflected in individual’s care plan. The service has access to a range of input from specialists such as community nurses, consultants as well as more routine dentists and G.P’S. All appointments were recorded with any necessary actions. Sewells (6a) DS0000019519.V339622.R01.S.doc Version 5.2 Page 14 Day to day administration and management of medicines was found to be satisfactory. Sewells (6a) DS0000019519.V339622.R01.S.doc Version 5.2 Page 15 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 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the care home and their families can feel confident that their concerns would be listened and people using the service would be safeguarded and protected. However, the homes own procedures are not being followed when managing service users finances, which may leave people at risk. EVIDENCE: A comprehensive complaints procedure was in place. A record was maintained of complaints made, detailing actions and outcomes as necessary but there has been no complaints received since the last inspection. Robust procedures were in place to ensure that people were protected from abuse and harm. The Hertfordshire County Council Safeguarding Adults (Adult Protection) Procedure was on display in the office, and regular training, and updates were routinely offered to staff. Each person has a cash-box and a money book where entries of expenditures and balanced were entered. However, it was noted that on several occasions there have been only one member of staff’s signature in the money book, which indicated that the homes own procedures were not being followed. Sewells (6a) DS0000019519.V339622.R01.S.doc Version 5.2 Page 16 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): 24-27 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Sewells is adequately maintained and furnished providing a homely, comfortable environment for people to live. People living here were encouraged to choose individual styles for their bedrooms, which helps to promote their independence. EVIDENCE: The premises were safe, accessible, comfortable, reasonably clean and free from offensive odours. Each room has sufficient light and ventilation. The bathroom and toilet provision is sufficient for the number of residents in the home. All rooms are for single accommodation. People’s bedrooms were personalised with individual’s belongings. Sewells (6a) DS0000019519.V339622.R01.S.doc Version 5.2 Page 17 The garden area was well maintained and provides a nice area for service users should they wish to go outside. There is one person living in the care home who smokes and used cigarette butts were found to be still a problem (a large amount was found in the dining room). The manager should demonstrate that there is a plan to rectified the situation. Sewells (6a) DS0000019519.V339622.R01.S.doc Version 5.2 Page 18 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): 31, 32, 33, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Vulnerable people are protected by the robust policies and procedures in relation to recruitment. Staffing levels were sufficient to meet individual’s identified needs. Staff have the appropriate skills and experience to respond to these needs. EVIDENCE: Whilst the policy and procedures relating to recruitment meet the national minimum standards, the inspector was unable to access personnel records. However, there was been no concerns raised or no information received or indication to suggest that the recruitment policies were not followed as found at previous inspections. The rotas seen demonstrated that adequate numbers of staff were provided at all times to meet the needs of people living in the care home. Regular agency workers supported the staff team as and when required. Sewells (6a) DS0000019519.V339622.R01.S.doc Version 5.2 Page 19 The staff team working at ‘Sewell’s’ is a small group of staff that appear to work well together. Supervision records showed that a system of all staff receiving one to one sessions was in place. Two members of staff spoken with said they were very well supported both by senior staff and the current acting manager. They said that they were receiving regular formal supervision and appraisal. The training planner was seen at this inspection and provided a satisfactory profile of training for staff. Staff had been provided with the opportunity to complete N.V.Q 2/3 and most staff were either qualified or in the process of completing their award. Sewells (6a) DS0000019519.V339622.R01.S.doc Version 5.2 Page 20 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): 37-43 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home can be confident that their views underpin all self monitoring, review and development by the home and that their rights and best interests are safeguarded by the home’s policies and procedures. The health, safety and welfare of staff and the people living in Sewells are generally promoted and protected. EVIDENCE: All appropriate written policies and procedures were in place. All records examined were well documented. Sewells (6a) DS0000019519.V339622.R01.S.doc Version 5.2 Page 21 Staff spoken to confirmed that regular fire drills did take place. However, it was noted that a list was not kept of all staff that had attended the fire drills. Safe working practices were maintained and the home complies with all relevant legislations to safeguard the health, safety and welfare of people living in the care home and staff. However, there was an electric reclining chair in the lounge which did not have a risk assessment carried out. Staff spoken to said that they have undertaken the mandatory training. Accidents, injuries, incidents of illness were recorded and reported. The home has a valid insurance cover for legal liabilities to employees, people living in the care home and third party persons to a limit commensurate with the level and extent of activities undertaken or to a minimum of £5 million. Sewells (6a) DS0000019519.V339622.R01.S.doc Version 5.2 Page 22 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 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 X 29 X 30 2 STAFFING Standard No Score 31 3 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 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 3 3 3 3 2 3 Sewells (6a) DS0000019519.V339622.R01.S.doc Version 5.2 Page 23 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. 1. Standard YA42 Regulation 13(4)(c) Requirement A risk assessment must be undertaken for the electric reclining chair used in the main lounge. This must identify the rationale for use and how information for safe use of the chair for staff will be cascaded. Timescale for action 20/07/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3 Refer to Standard YA23 YA30 YA42 Good Practice Recommendations 2 staff should sign for money used on behalf of service users as per home’s procedure. A plan is required to rectify the storing of used cigarette butts in the dining room. A list of the names of staff who have attended the fire drills should be kept. Sewells (6a) DS0000019519.V339622.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 Sewells (6a) DS0000019519.V339622.R01.S.doc Version 5.2 Page 25 - 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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