Inspection on 13/11/08 for Shaftesbury Rest Home

This inspection was carried out on 13th November 2008.

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

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

Shaftesbury Rest Home 13/03/07

Shaftesbury Rest Home 24/01/06

Shaftesbury Rest Home 28/10/05

Shaftesbury Rest Home 23/11/04

Shaftesbury Rest Home 14/05/04

Shaftesbury Rest Home 11/11/03

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Shaftesbury Rest Home 49 Shaftesbury Avenue Highfield Southampton Hampshire SO17 1SE     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Mick Gough     Date: 1 3 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Shaftesbury Rest Home 49 Shaftesbury Avenue Highfield Southampton Hampshire SO17 1SE 02380584478 Telephone number: Fax number: Email address: Provider web address: northoverresthome@tiscali.co.uk Name of registered provider(s): Name of registered manager (if applicable) Ms Paula Smith Type of registration: Number of places registered: Mrs Heather Northover,Mr Roy Clive Northover care home 17 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: A maximum of 3 service users in the categories DE and MD may be accommodated between the age of 55-64 years at any one time Date of last inspection Brief description of the care home Shaftesbury Rest Home is a care home providing care and support for 17 older people with care and support needs associated with old age, dementia and mental health. Mr and Mrs Northover have owned the home for the past eighteen years. Ms Paula Smith oversees the day-to-day management of the home. The home is situated in the residential area of Highfield and within walking distance of Portswood shopping centre. Care Homes for Older People Page 4 of 27 Over 65 17 17 17 0 0 0 Brief description of the care home Accommodation is spread over two floors and comprises of nine single bedrooms and four shared rooms. The scale of fees will depend on the type and level of support required and a full range of fees are available from the home. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This report details the evaluation of the quality of the service provided at Shaftsbury Rest Home and takes into account the accumulated evidence of the activity at the home since the last inspection, which was carried out in March 2007. The inspection took into account the homes Annual Quality Assurance Assessment (AQAA), which was returned prior to the visit. Comment cards which were sent out to residents and staff and we received back 6 questionsaires from residents, 5 from staff and one from a care manager. All responses we received back were positive about the service. An unannounced site visit to the home took place on 13 November 2007 and further Care Homes for Older People Page 6 of 27 evidence for this report was obtained by touring the home, reading and inspecting records and by observing the interaction between staff and residents. It was also possible to speak with 3 members of staff, 6 residents, 1 visitor to the home and the homes manager who assisted the inspector throughout the visit. The home is registered to provide support for 17 residents and at the time of the inspection there were only 15 residents accommodated at the home. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 Care Homes for Older People Page 8 of 27 240 7535. Care Homes for Older People Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. New service users have a needs assessment undertaken prior to moving into the home this allows both the home and the service users to ensure that the home can meet the service users needs. The home does not provide intermediate care. Evidence: The manager or one of the senior care staff carries out an individual needs assessment prior to any new service users moves in. The home uses an assessment form and needs assessments were seen for 3 service users. Assessments include information on, Diet including preferences, sight and hearing, communication, oral health, foot care, mobility, history of falls, continence, mental state and cognition, social interests and hobbies, religious and cultural needs, personal safety and risks, family involvement, medication & personal care skills and needs. The initial assessment form is used alongside any social service assessments to make up the initial plan of care. Care Homes for Older People Page 11 of 27 Evidence: Intermediate care is not provided by the home. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health, personal and social care needs of residents are set out in an individual plan of care and provide staff with the information they need, however care plans would benefit from out of date information being removed. Users of the service are generally protected by the homes policies and procedures for dealing with medicines, however the home must ensure that the storgae arrangments for any controled drugs meet relevant regulations. Residents are treated with dignity and respect and their right to privacy is upheld. Evidence: Care plans were seen for 3 service users and plans gave information for staff on the care needs of individuals. Care plans were clear and easy to follow and staff spoken with were aware of the residents care needs. Residents spoken with said that their care needs were met by the home and those spoken with were aware that there was a plan of care in place and a number of residents had signed their plans. Care plans had Care Homes for Older People Page 13 of 27 Evidence: information on abilities, problems and needs and gave staff good information on how the resident would like their care to be given. Care plans had a number of recording sheets so staff could record any health care appointments, however there was a lot of out of date information in care plans some dating back to 2001. The manager told us that she understands the need to ensure that only relevant information is kept in the care plans and told us that she intends to remove all out of date information. Daily recording is carried out by staff at the end of each shift and this was clear and provided information on how residents had been during the shift and there was a good handover between staff going off duty and those coming on duty. We looked at the risk assessments in the 3 plans viewed. There were risk forms in place to indicate if there was any risk identified and there was information on how the risk could be minimised or reduced. Residents at the home are registered with a local GP surgery although they may have different GPs. Residents may keep their own GP if they wish. We were informed by the manager that there was some problems in obtaining dental care for residents, she had contacted NHS direct and also the dental help line but they had been unable to help, she told us that she is awaiting contact from the local primary care trust to give her more information on dental care available in the area. The GP surgey provides community nurses who visit as and when required and other healthcare professionals are arranged through GP refereals. A visiting optician provides eye care although residents may use their own private optician if they wish. A visiting chiropodist calls every 4 to 6 weeks. Relatives and residents who completed surveys all indicated that the home provides residents with good access to health care services and that the health care needs are met. Those residents spoken to on the day of the visit said that they were very happy with the care that they receive and said that there health care needs were being met and that they could see a doctor whenever they needed to. The home uses a monitored dose system provided by a local pharmacist for residents medication and all staff at the home who administer medication have received appropriate training. The home has a clear policy and procedure regarding medication and medication administration record sheets were viewed and these were found to be up to date. The medication cabinet was looked at and a sample of stocks was checked against records and found to be correct. The home currently holds controlled drugs for one resident, however the storage facilities do not meet the standards as laid down in Misuse of Drugs (Safe Custody) Regulations 1973 which state that they must be stored in a proper Controlled Drugs Cupboard. In brief, the requirements for CD storage are Metal cupboard of specified gauge· Specified double locking mechanism· Fixed to a solid wall or a wall that has a steel plate mounted behind it· Fixed with either Rawl or Rag bolts. Suppliers of CD cabinets can confirm that a cupboard meets the legal requirements. Care Homes for Older People Page 14 of 27 Evidence: Residents spoken to were very positive about the care received at the home and all said that staff were very caring, helpful, and friendly and stated that they were always treated with dignity and respect. Observations made on the day of the visit showed that residents and staff get on well together and staff were observed interacting with residents in a positive way and they were seen to treat them with dignity and respect. Staff knocked on residents doors before entering and used their preferred form of address when talking to them. Comments from relatives and residents who completed surveys were all positive about the care provided and staff told us that everyone gets on well together and residents also confirmed this. Care Homes for Older People Page 15 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a range of activities for residents, which meet their expectations and tthe recreational interests of residents at the home are provided for. Residents are able to maintain contact with family and friends and visitors are welcome at any time. Residents are supported to exercise choice and control over their lives as much as possible and they are provided with a balanced diet in pleasant surroundings at time convenient to them Evidence: Activities at the home are displayed on the notice board in the home and these include: visiting entertainers, games and puzzels, bingo, hand massage, watching TV and occasional trips to the local pub. There was a good rapport between residents and staff and we observed staff spending time with residents and staff spoken with said that they spend as much time as possible chatting and playing games or just discussing things on the TV. Residents spoken to indicated that they were happy with the activities provided and we were told that the visiting entertainers were very good. On the day of the visit a singer was entertaining residents in the lounge. The home has a clear visitors policy and there are no set times, visitors sign in at the Care Homes for Older People Page 16 of 27 Evidence: home and a visitors book is kept. Residents told us that their visitors were always made welcome. The manager told us that visitors are always welcome, however they are asked to respect meal times. One resident has her husband who visitis regularly and we were told that he often stays and has a meal with his wife. We observed staff supporting residents and they were consulted about day to day issues in the home, we heard staff discussing what residents wanted to watch on the TV, and they were seen offering choices of drinks, and residents spoken to confirmed that they are able to make informed choices and are able to control their own lives as much as possible, they said that they were consulted regularly and that staff at the home respected their views and that if they wanted anything all they had to do was ask. The majority of residents had bought some of their own possessions into the home and rooms had been personalised. There is a four week menu and this is changed regularly. Residents said that they were very happy with the food provided by the home. They stated that the food was plentiful and good. We were told that the home keeps a record of food provided and that alternatives meals were available if the main course was not to residents liking. Residents are able to eat their meals in the dining room or elsewhere if they prefer. We observed lunch being prepared and this was minced beef, potatoes and fresh vegatables followed by fruit and ice cream. Most residents have thier meals in the dining room and meals at the home were unhurried and staff provide suitable support for residents if needed. Care Homes for Older People Page 17 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a simple, clear and accessible complaints procedure, which includes timescales for the process and any complaints are logged and responded to appropriately. The homes policies and procedures help protect residents from any form of abuse. Evidence: The homes completed AQAA told us that there have been no complaints made since the last inspection and this was confirmed by the manager on the day of the visit. We saw that the home has a clear complaints procedure, which contains all of the required information and residents spoken to were confident about raising any concerns they may have and stated that they would address any complaint they may have to a member of staff. Staff members spoken to were aware of the complaints procedure and said that they would support any resident to make a complaint if they wished to do so. All staff has received training on adult protection, and the manager and staff spoken to were aware of their responsibilities in this area. The home had a copy of the Hampshire adult protection procedure Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users live in a safe and well-maintained environment and have access to comfortable indoor and outdoor facilities and the home was clean, pleasant and hygienic. Evidence: We toured the building with the homes manager and all areas of the home were clean and tidy and it was safe and well maintained and provided aids and equipment to meet the care needs of the residents. We were told that there is a rolling programme of decoration and this is on a needs led basis with rooms being decorated as they become vacant. One bathroom has recently been completely refurbished and there are plans to refurbish other areas of the home. We saw the luandry and this was equiped with an industrial washing machines and 2 domestic tumble driers. The home has a contract for the maintenance and repair of these machines. There was a good infection control policy and all staff complete training in this area and there are alcohol gel dispensers situated around the home to help reduce the spread of infection. Staff spoken with told the inspector they have received training in infection control and are provided with appropriate protective clothing. Care Homes for Older People Page 19 of 27 Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing numbers and the mix of staff currently meets the needs of residents. Staff morale was good and there was a good rapport between residents and staff. Residents are protected by the homes recruitment procedures and the home provides training for staff to enable staff to support people effectively. Evidence: The staff rota showed that there is sufficient staff on duty to meet the needs of residents. Staffing numbers were discussed with the manager and she stated that she felt that, staffing levels were sufficient, however staffing numbers would be kept under review. All residents spoken to said that they felt that staffing levels were adequate and comments received included the staff are very goodl there is always someone around and I am well looked after. Staff spoken to also said that they felt that staffing levels were sufficient. The home employs a total of 14 care staff and has 8 members of staff who are qualified to NVQ level 2 and one member of staff who has NVQ level 3. The manager told us that the home would support staff to obtain National Vocational Qualifications. Recruitment records were seen for 2 members of staff and these contained all of the Care Homes for Older People Page 21 of 27 Evidence: required information including, application form, 2 x references, photo, declaration of offenders, passport, birth certificate CRB/POVA and contract of employment. We were told by the manager that there is a very low staff turnover and the majority of staff have been working at the home for between 5 and 23 years. Staff training records were looked at and the manager showed us a training matrix, which showed that training is provided in, first aid, food hygiene, moving and handling, fire, infection control, adult protection, medication, H & S, dementia care, challenging behaviour, communication, risk assessment training, death and bereavement and principles of care. Training is carried out using videos and this is backed up by question sheets and certificates of training. The home also uses outside training organisations to train staff. A suitable induction programme is in place, which is in line with skills for care. Staff spoken to confirmed that they received a thorough induction and they said that training is very good with refresher training available they said that they are provided with appropriate training in order to carry out their care tasks. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed by a person fit to be in charge and able to discharge her responsibilities fully. The home has a quality assurance system in place to seek the views of residents, relatives and other professionals to measure the effectiveness of the service. There are robust systems in place for the safekeeping of residents money and the health, safety and welfare of service users and staff are promoted and protected. Evidence: The manager has been in post for over 15 years and has completed the Registered Managers Award, she operates an open door policy and is able to manage the service effectively, she is respected by her staff and they told us she is always approachable. The manager told us that she undertakes regular training to update her skills. The home has an effective quality assurance system in place and questionnaires are sent out to residents, relatives, staff, heath care professionals and other interested Care Homes for Older People Page 23 of 27 Evidence: parties, responses to questionnaires are kept in a folder at the home and we were able to view these and they showed that they were happy with the service provided. The home holds regular staff and residents meetings and the manager keeps minutes of these meetings. The home manages the finances for 2 residents and they also keep some personal spending money for residents, a clear record is kept of all transactions and this provides a clear audit trail. There is an in date fire risk assessment for the building and regular health and safety monitoring takes place. The fire logbook was inspected and all appropriate testing and checks have been recorded. Appropriate certificates were in date for gas safety, fire alarms systems and equipment, private electrical equipment, lift hoists and there was an in date certificate for the homes fixed electrical wiring. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 The home must ensure that any controlled drugs are kept in a cupboard which meets the requirements of the Misuse of Drugs (Safe Custody) Regulations 1973. This is to ensure that all controlled drugs are kept secure at all times. 14/01/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!