Inspection on 21/09/06 for Shalder House Extra Care

This inspection was carried out on 21st September 2006.

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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Shalder House Extra Care 26/01/06

Shalder House Extra Care 01/11/05

Shalder House Extra Care 18/02/05

Shalder House Extra Care 13/05/04

Shalder House Extra Care 02/02/04

Shalder House Extra Care 28/11/03

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Shalder House Extra Care Shalder House Medway Road Gillingham Kent ME7 1NY Lead Inspector Andrea Leverett Unannounced Inspection 21st September 2006 10:00 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.V313682.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 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.V313682.R01.S.doc Version 5.2 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 Julie Morris Care Home 11 Category(ies) of Old age, not falling within any other category registration, with number (11) of places Shalder House Extra Care DS0000035709.V313682.R01.S.doc Version 5.2 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. 26th January 2006 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 are 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.V313682.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection which took place on the 21st and 22nd of September 2006. The visit was spent talking directly with service users privately, staff and the manager. Some judgements about quality of life and choices were taken from direct conversation with service users followed by discussion with the acting manager and care records inspected. A partial tour of the premises was undertaken on this occasion. Service users spoken to during the inspection gave positive feedback about the staff and services provided by Shalder House and the inspector is confident that, overall the outcomes for service users continues to be good. What the service does well: What has improved since the last inspection? What they could do better: Considering the increase in the services registration from 7 to 11, the quality of the support that service users receive at night might be improved upon by considering a move to waking night instead of sleep in staff. Shalder House Extra Care DS0000035709.V313682.R01.S.doc Version 5.2 Page 6 Service users would benefit from staff having undertaken a formal induction procedure. 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.V313682.R01.S.doc Version 5.2 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.V313682.R01.S.doc Version 5.2 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): 2,3,6 The quality of service in this outcome group has been judged as good. Service users know that their rights and needs are defined and will be met before they enter the service and that they will be helped to maximize their independence and return home. EVIDENCE: Shalder House now has a Service User contract in place, which includes the terms and conditions of their stay. An inspection of the contract includes all the information required to ensure service users rights are defined and protected. Service users are referred to the service via the joint Social Services and Health’s Rapid Response team or via Care Management. Service users Care Files showed that appropriate Care Manager/Health assessments are undertaken before a person is admitted to the service. The services own assessment is also undertaken before an admission is agreed. Records show Shalder House Extra Care DS0000035709.V313682.R01.S.doc Version 5.2 Page 9 that residents continue to be supported by Occupational Therapists and together with the support staff care plans are put in place to aid recovery and support their return home if appropriate. Shalder House Extra Care DS0000035709.V313682.R01.S.doc Version 5.2 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): 7,8,9,10 The quality of service in this outcome group has been judged as good. Service users benefit from having their Health and Personal care needs defined and fully met. Subject to appropriate risk assessments service users are responsible for their own medication and are protected by a safe Medication Administration System. Service users feel they are treated with respect and their right to privacy is upheld. EVIDENCE: Discussion with service users and an inspection of their care plans showed that their health and personal care needs were recorded and acted upon. Records showed that appropriate access to Health Care professionals including specialist services was facilitated. Care plans also included comprehensive risk assessments, likes and dislikes, Mobility issues, communication, psychological support needed and Nutrition. Medication files showed Medication was being monitored and administration appropriately. Discussion with service users and medication records seen Shalder House Extra Care DS0000035709.V313682.R01.S.doc Version 5.2 Page 11 showed that, subject to appropriate risk assessments, service users are encouraged to administer their own medication. Each service user has a locked cupboard for storing medication. All residents have their own flats at Shalder House and staff were observed knocking on doors and respecting their privacy. Feedback from service users regarding the manner of staff support was very positive. Comments included “ I can only say they have been more than helpful, very good to me.” “ Staff are brilliant, can’t praise them enough, they look after you in every way.” Shalder House Extra Care DS0000035709.V313682.R01.S.doc Version 5.2 Page 12 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): 12,13,14,15 The quality of service in this outcome group has been judged as good. Service users find that the lifestyle experienced in the service matches their expectations and preferences and they are encouraged to exercise control and choice over their lives. Service users benefit from having individually planned meals, which they have chosen and if appropriate have shopped for and cooked for themselves. EVIDENCE: Service users spoken to say they were happy with the service provided and felt that the range of activities offered were appropriate to their needs and preferences. Service users said that family and friends were made welcome and it was evident from discussion that the service communicated effectively with them in the best interests of service users. Service users buy, choose and cook their own food at Shalder House. This is an integral part of the rehabilitation that is carried out. If service users can’t physically go out and shop then staff will do this on their behalf. Each flat has its own kitchenette, which includes a cooker microwave and fridge freezer. Service users said they were happy with the cooking facilities provided and Shalder House Extra Care DS0000035709.V313682.R01.S.doc Version 5.2 Page 13 confirmed that their choices were respected when food was bought on their behalf. Shalder House Extra Care DS0000035709.V313682.R01.S.doc Version 5.2 Page 14 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): 16,18 The quality of service in this outcome group has been judged as good. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users can be confident that they will e protected from abuse. EVIDENCE: Shalder house has an appropriate complaints procedure and an adult protection procedure that includes local authority protocols and procedures and also includes whistle blowing. Staff spoken to and records seen evidenced that staff undertakes Adult Protection training. The service has had no complaints in the last 12 months and service users spoken to say they would feel comfortable raising concerns with staff and felt that they would be listened to. Shalder House Extra Care DS0000035709.V313682.R01.S.doc Version 5.2 Page 15 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): 19,26 The quality of service in this outcome group has been judged as good. Service users live in a safe, comfortable and well-maintained environment, which is clean and free from offensive odours throughout. EVIDENCE: A partial tour of the service was undertaken, which included three service users flats, bathrooms and communal areas. Shalder House is decorated and furnished to a good standard with equipment and facilities maintained appropriately. The individual flats seen as part of the site visit were clean and free from offensive odours and service users said they were happy with the standards of cleaning. Shalder House Extra Care DS0000035709.V313682.R01.S.doc Version 5.2 Page 16 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): 27,28,29,30 The quality of service in this outcome group has been judged as good. During waking hours service users needs are met by the numbers and skills mix of staff but more could done to improve the quality of the service provided at night. On the whole staff are trained and competent to do their jobs but more could be done to develop a robust induction programme. EVIDENCE: The staff rota was inspected and this showed that in most cases 3 staff was on duty AM and PM. In addition to this the service has a Manager and an Administrator. The records showed that the service never goes below 2 staff on shift at any time during waking hours and agency staff are used to maintain safe staffing levels when necessary. Discussion with service users and observation on the day demonstrated that the staffing levels during waking hours was meeting residents needs. The service is still only using sleep in staff during the night and a requirement was made at the last inspection that this should be risk assessed. The manager informed the inspector that the risk assessment is being currently undertaken. Records seen and discussion with staff showed that a range of training was being undertaken. The manager has identified that the services staff induction procedure needs developing and a requirement has been made to this effect. Shalder House Extra Care DS0000035709.V313682.R01.S.doc Version 5.2 Page 17 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): 31,33,35,38 The quality of service in this outcome group has been judged as good. Service users benefit from a service, which is run and managed by a person who is fit to be in charge and who manages the service in their best interests. Service users’ financial interests are safe guarded and the health safety and welfare of service users and staff are promoted and protected. EVIDENCE: Shalder House has a new registered manager who had been in post for two weeks at the time of the inspection. The inspector was impressed with her evaluation of the service. A lot of work has been undertaken around identifying areas in need of development and developing a robust monitoring system. Staff spoken to felt supported by the new manager and evidence was seen that she is very proactive in developing the service in the best interests of service users. Shalder House Extra Care DS0000035709.V313682.R01.S.doc Version 5.2 Page 18 Each flat has a lockable storage facility and the service also has a safe were monies and valuables can be kept safely. A tour of the premises and evidence taken from the Pre inspection questionnaire demonstrated that the service was being maintained appropriately. Individual service users risk assessments were also seen to be in place. Shalder House Extra Care DS0000035709.V313682.R01.S.doc Version 5.2 Page 19 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 3 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Shalder House Extra Care DS0000035709.V313682.R01.S.doc Version 5.2 Page 20 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 OP27 Regulation Reg 18 Requirement Timescale for action 20/11/06 2 OP30 Reg 18.1(c ) (i) The registered person is required to ensure that the services practice of using sleep in staff during the night is risk assessed and the findings presented to the commission. Action plan by: The registered person must 20/11/06 ensure that staff receives appropriate induction training. Action plan by: 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.V313682.R01.S.doc Version 5.2 Page 21 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.V313682.R01.S.doc Version 5.2 Page 22 - 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!