Inspection on 30/08/05 for Sewells (6a)

This inspection was carried out on 30th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Sewells (6a) 14/05/07

Sewells (6a) 02/08/06

Sewells (6a) 01/12/05

Sewells (6a) 21/01/05

Sewells (6a) 10/08/04

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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 Sewells (6a) 6a Sewells Welwyn Garden City Hertfordshire AL8 7AQ Lead Inspector Marian Byrne Unannounced 30 August & 17 October 2005 th th 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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) I52 S19519 Sewells V237796 30805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Sewells Address 6a Sewells, Welwyn Garden City, Hertfordshire, AL8 7AQ 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) 01707 395187 01707 321344 Life Opportunities Trust Ms Ruth Shannon CRH Care Home, PC Care Home only 7 Category(ies) of LD Learning Disability 7, LD(E) Learning Dis registration, with number over 65 7, PD Physical Disability 7. of places Sewells (6a) I52 S19519 Sewells V237796 30805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection 21/01/05 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 the service users.The aim of the home is to enable service users 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 service users have a wide range of activities, experiences and relationships available to them. Sewells (6a) I52 S19519 Sewells V237796 30805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out over two visits. The service users were well presented and appeared to be well looked after. The home was clean and fresh. The inspector observed very good interaction between staff and service users. On the first visit there were three service user in the home, one recently admitted. The new service user has challenging behaviour. For most of the inspection there were two carers in the home. Part way through the inspection one member of staff left the home to pick up other service users from the day centre. This left one member of staff who had been in post three weeks. Given the nature of the service users left in the home the inspector felt that this was not appropriate and could have left both the service users and member of staff at risk. An immediate requirement was left to ensure that this did not happen again. The home continues to provide a good service to its service users. One new service user has been admitted since the last inspection. A full assessment was carried out and the admission was carried out in a timely manner. What the service does well: What has improved since the last inspection? What they could do better: The home needs to be aware that the best laid plans may go wrong and contingently plans must be put in place to deal with any emergencies. Sewells (6a) I52 S19519 Sewells V237796 30805 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. Sewells (6a) I52 S19519 Sewells V237796 30805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Sewells (6a) I52 S19519 Sewells V237796 30805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4&5. The home has and reviews all the necessary documentation to ensure service users have enough information to make an informed choice. Service users are invited to the home prior to moving in. A thorough assessment of need and wishes has been made on all service users. EVIDENCE: The home updates its Statement of Purpose and Service Users’ Guide regularly and they reflect the service the service users can expect in the home. The assessment of the new service users contained all the necessary information pertaining to the health, welfare and social needs of the service users. One service users may not be in a home that best meets her needs. She is due to have an indepth residential assessment to assertain the best place for a her. Sewells (6a) I52 S19519 Sewells V237796 30805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8,9&10. The service users have their needs and choices met. All information on service users is stored confidentially. EVIDENCE: Both care plans that were examined contained a commendable wealth of information that should ensure that there would be an adequate continuity of care provision in terms of health and welfare if the regular care team were not available. Care plans are reviewed every three months and each describes the roles and responsibilities of the service user’s key worker. On the first day of the inspection one service user was on holiday accompanied by two staff members. Sewells (6a) I52 S19519 Sewells V237796 30805 Stage 4.doc Version 1.40 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14,15,16&17. Service users are assisted in living a lifestyle that respects their rights offers development, choice and involvement of family, friends and the local community. They are offered a healthy and varied diet. EVIDENCE: On the first day of the inspection the staff had prepared a party for the service users and outside entertainment was provided. The most recently admitted service users is engaged to be married. Her fiancé visits regularly and they are accorded privacy to conduct their relationship. Where possible service users go to day centres. Service users are assisted in making choices in relation to their lives. Staff are dedicated to ensuring service users have a good quality of life. The home had a good supply of fresh food and supplies of good quality frozen, tinned and dry food. Service users likes and dislikes are on their care plans and were known to staff. There was a good variety of party food available for the party. On the second day of the inspection one service user who is very frail had one to one time from an outreach worker. Some of the service users like to eat out in local restaurants. The staff observed were kind, caring and compassionate. Sewells (6a) I52 S19519 Sewells V237796 30805 Stage 4.doc Version 1.40 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not assessed. EVIDENCE: Sewells (6a) I52 S19519 Sewells V237796 30805 Stage 4.doc Version 1.40 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) This standard was not inspected. EVIDENCE: Sewells (6a) I52 S19519 Sewells V237796 30805 Stage 4.doc Version 1.40 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,28,29&30. The environment was clean fresh and odour free. The home has the equipment necessary to ensure the safety of the service users. EVIDENCE: On both days of the inspection the home was clean, fresh and odour free. All rooms were personalised and homely. The home has appropriate lifting and moving equipment. The home meets the space requirements of the Care Standards Act 2000. To encourage privacy service users have the facility to lock their rooms, one service user, uses this option. The home has had a new kitchen installed since the last inspection. This is bright and domestic in style. One door in the home was propped open using a door wedge. An immediate requirement was left to ensure this does not happen again. On the second day of the inspection the Registered Manager had purchased automatic door closures for use in the event of a fire. These were to be installed the following day. Sewells (6a) I52 S19519 Sewells V237796 30805 Stage 4.doc Version 1.40 Page 14 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37. For a short period during the inspection the service users could have been at risk through the number of staff on duty. EVIDENCE: For a period of 10 minutes three service users were left in sole charge of one staff member who had been in post for three weeks. This situation happed through an unexpected development during the day. The home must have contingency plans in place to ensure this does not happen again. An immediate requirement was left. Sewells (6a) I52 S19519 Sewells V237796 30805 Stage 4.doc Version 1.40 Page 15 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 In the event of a fire the service users could be put at risk through the use of door wedges. EVIDENCE: These standards were not inspected, however the home appears to be well managed. They will be fully inspected at the next inspection. One door was propped open using a door wedge. This could potentially put service users at risk in the event of a fire. An immediate requirement was left to ensure this does not re-occour. Sewells (6a) I52 S19519 Sewells V237796 30805 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 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x x x x 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Sewells (6a) Score x x x x Standard No 37 38 39 40 41 42 43 Score x x x x x 2 x I52 S19519 Sewells V237796 30805 Stage 4.doc Version 1.40 Page 17 YES 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 20 Regulation 13(2) Requirement The manager must ensure that there are no gaps in the recording of the administration of medication. The Registered Manager must ensure the safety of service users by eliminating the use of door wedges. The Registered Manager must ensure the safety of service user by ensuring that staffing levels are adequate. Timescale for action January 2005. Immediate. 2. 42 23(4)(c) (iii) 18(1)(a) 3. 36 Immediate. 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 20 Good Practice Recommendations It is recommended that a chart be devised for the recording of the administration of creams and that chart be kept wherever the cream is usually administered. The medication administration record (MAR chart) should then refer to the separate cream chart. The registered person should ensure that contractors of the service provide sufficient funds to allow service users to have the option of a seven-day holiday as part of the basic contract price. (This has been brought forward from I52 S19519 Sewells V237796 30805 Stage 4.doc Version 1.40 Page 18 2. 14 Sewells (6a) previous inspections and it is recognised that the solution to the issue may be out of the registered person’s remit). Sewells (6a) I52 S19519 Sewells V237796 30805 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Hertfordshire Area Office Mercury House, 1 Broadwater Road Welwyn Garden City Hertfordshire, AL7 3BQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Sewells (6a) I52 S19519 Sewells V237796 30805 Stage 4.doc Version 1.40 Page 20 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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