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Inspection on 01/11/05 for Shalder House Extra Care

Also see our care home review for Shalder House Extra Care for more information

This inspection was carried out on 1st November 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Service users benefit from a staff team that are trained to meet their needs. Service users benefit from a staff team that treat them with dignity and respect and ensure that their choices are respected.

What has improved since the last inspection?

Service users now benefit from a dedicated rehabilitation room, which has been redesigned to allow more space and easier access to the kitchen area. The chances of service users undergoing successful rehabilitation has been improved by staff receiving rehabilitation training.

What the care home could do better:

Service users rights and choices would be better protected if the Home had a contract in place, which included terms and conditions. The effectiveness of the service could be improved by ensuring all staff receives regular supervision. More could be done to evidence that the service is being maintained appropriately for the benefit of service users. The quality of the service users environment could be improved by ensuring appropriate mop and grip rails are provided in the ensuite and kitchen areas of the flats.

CARE HOMES FOR OLDER PEOPLE Shalder House Extra Care Shalder House Medway Road Gillingham Kent ME7 1NY Lead Inspector Andrea Leverett Announced Inspection 1st November 2005 9:45 X10015.doc Version 1.40 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 Shalder House Extra Care DS0000035709.V254676.R01.S.doc Version 5.0 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 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. Shalder House Extra Care DS0000035709.V254676.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Shalder House Extra Care Address Shalder House Medway Road Gillingham Kent ME7 1NY 01634 852917 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) Medway Council Mrs Jacqueline Ann Noyce Care Home 7 Category(ies) of Old age, not falling within any other category registration, with number (7) of places Shalder House Extra Care DS0000035709.V254676.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. It is recommended that all bathrooms be upgraded and fitted with appropriate baths and adaptations to meet the needs of the service user group. 18th February 2005 Date of last inspection Brief Description of the Service: Shalder House is one of a number of homes managed by Medway Council Social Services. The home offers 24-hour care for a maximum of 11 service users for the purpose of rehabilitation. It is based within a sheltered housing complex also managed by Medway Council. The service occupies 11 flats within the complex, plus a rehabilitation room, small lounge, which is none smoking and an office. The service users also have access to a communal lounge, a laundry and bathroom facilities, which are shared with sheltered housing tenants. All the flats have en-suite facilities, which comprise of a toilet and a washbasin. There is an emergency call system in place and all 11 flats have telephone and television points. There is a shaft lift access between floors. Shalder House Extra Care DS0000035709.V254676.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, the first in the year running from April 1st 2005 to March 31st 2006. It took place on the 1st February 2005. The visit was spent talking directly with residents privately and with relatives present; 2 care staff, the deputy manager and the registered manager. Some judgements about quality of life and choices were taken from direct conversation with residents and their relatives and observation followed by discussion with support staff and evidencing records held at the home. A tour of the premises was undertaken. Residents and relatives spoken to during the inspection and comment cards received gave positive feedback about the staff and services provided by this respite and rehabilitation service. The inspector is confident that, overall the outcomes for residents are good. What the service does well: What has improved since the last inspection? Service users now benefit from a dedicated rehabilitation room, which has been redesigned to allow more space and easier access to the kitchen area. The chances of service users undergoing successful rehabilitation has been improved by staff receiving rehabilitation training. Shalder House Extra Care DS0000035709.V254676.R01.S.doc Version 5.0 Page 6 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. Shalder House Extra Care DS0000035709.V254676.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Shalder House Extra Care DS0000035709.V254676.R01.S.doc Version 5.0 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 the following standard(s): 2,6 Because the home’s service user contract and statement of terms and conditions are still in draft form, service users cannot be confident that their rights within the service are protected. Service users benefit from a service, which helps them to maximise their independence and where possible, their return home. EVIDENCE: The service user contract and statement of terms and conditions is still in draft form and has not yet been agreed by the authorities legal department, the requirement in relation to this therefore remains outstanding. Records viewed and discussion with service users demonstrated that they were supported to achieve maximum independence and return home where possible. Several service users spoke about feeling more confident and being supported by staff to be independent. It was also clear that Occupational Therapists worked closely with staff in the best interests of service users and Shalder House Extra Care DS0000035709.V254676.R01.S.doc Version 5.0 Page 9 records also showed that staff are now receiving ongoing rehabilitation training from the Occupational Therapists. Shalder House Extra Care DS0000035709.V254676.R01.S.doc Version 5.0 Page 10 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 the following standard(s): 10, Service users can be confident that they will be treated with dignity and respect. EVIDENCE: Discussion with service users evidenced that they felt respected by staff. One service user stated ”Nothing is too much trouble, staff are kind and everything is taken care of.” Another stated “ They definitely helped me get back on my feet and I can call for assistance whenever I like and staff come straightaway. I have nothing but praise for them all.” Shalder House Extra Care DS0000035709.V254676.R01.S.doc Version 5.0 Page 11 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 the following standard(s): None of the above was inspected on this occasion EVIDENCE: Shalder House Extra Care DS0000035709.V254676.R01.S.doc Version 5.0 Page 12 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 the following standard(s): None of the above was inspected on this occasion. EVIDENCE: Shalder House Extra Care DS0000035709.V254676.R01.S.doc Version 5.0 Page 13 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 the following standard(s): 19,21,22,23,26 Whilst service users generally benefit from living in a clean and appropriately maintained environment that suits their needs, some minor improvements are needed in the home to ensure that the independence of service users is maximised. More could be done to ensure that the service users environments are designed to maximise their independence. EVIDENCE: A tour of the service was undertaken. Service users flats were clean, well maintained and odour free. Service users spoken to thought that their living accommodation was comfortable and homely. One service user explained that she had difficulty moving around her kitchen because of lack of mop rails. It was also noted that service users en suite facilities could also benefit from longer grip rails. A requirement has been Shalder House Extra Care DS0000035709.V254676.R01.S.doc Version 5.0 Page 14 made the service assess service users needs in these areas and take action to provide appropriate adaptations as identified. An inspection of the services maintenance records showed that some maintenance certificates were not available for inspection and a requirement has been made regarding this. Shalder House Extra Care DS0000035709.V254676.R01.S.doc Version 5.0 Page 15 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28,29,30 Service users are supported and protected by a well-trained and competent staff team. EVIDENCE: Records viewed and discussion with staff evidenced that a range of service specific and mandatory training was provided for staff and over 50 of staff have undergone NVQ2 or above. A sample of staff personal files was inspected and it was evident that the services recruitment and selection procedure was effective. Files included all the necessary checks and information to establish prospective staffs competence and appropriateness. Shalder House Extra Care DS0000035709.V254676.R01.S.doc Version 5.0 Page 16 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,36,38 Service users benefit from a service that is managed in their best interests in an open and transparent way. The effectiveness of the service could be improved by ensuring all staff receive regular supervision. More could be done to evidence that the service is being maintained appropriately. EVIDENCE: Both service users and staff spoken to felt that the management team was approachable and accessible. The manager was seen interacting with service users in a respectful and sensitive manner. Staff also confirmed that regular staff meetings take place and they are able to contribute to the agenda. Shalder House Extra Care DS0000035709.V254676.R01.S.doc Version 5.0 Page 17 Records showed that staff are not currently receiving regular supervision and discussion took place regarding the need to ensure that this is addressed. There was evidence that the maintenance of the building was being managed effectively, however several documents such as gas and fire certificates were not kept in the building but were retained centrally. The need to ensure that the service can evidence that it is being maintained appropriately was discussed with the caretaker and manager and a requirement has been made regarding this. Shalder House Extra Care DS0000035709.V254676.R01.S.doc Version 5.0 Page 18 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 1 X X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 2 X 3 2 3 X X 3 STAFFING Standard No Score 27 X 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 X X X 2 X 2 Shalder House Extra Care DS0000035709.V254676.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? Yes 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 OP36 Regulation 18.2 Requirement The registered person must ensure that all staff receive regular supervision. The registered person must ensure that evidence is made available sufficient to establish that service is being maintained appropriately. The Registered Person must ensure that all service users receive a statement of terms and conditions, which includes all the information required by this standard. Timescale for action 25/12/05 2 OP38 23.2(b) & Schedule 4 5c 25/12/05 3 OP2 25/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Shalder House Extra Care DS0000035709.V254676.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Shalder House Extra Care DS0000035709.V254676.R01.S.doc Version 5.0 Page 21 - 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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