Inspection on 10/10/05 for Shaldon House

This inspection was carried out on 10th October 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Shaldon House 10/07/07

Shaldon House 27/01/07

Shaldon House 27/06/06

Shaldon House 24/01/06

Shaldon House 07/12/04

Shaldon House 15/06/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Shaldon House 77 Shaldon Road Horfield Bristol BS7 9NN Lead Inspector Peter Still Unannounced Inspection 10th October 2005 1300:0 Shaldon House DS0000026554.V255221.R01.S.doc Version 5.0 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 Shaldon House DS0000026554.V255221.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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Shaldon House DS0000026554.V255221.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Shaldon House Address 77 Shaldon Road Horfield Bristol BS7 9NN 0117 9518884 0117 9521492 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) Parkcare Homes (No. 2) Limited Mrs Lisa Marie Cole Care Home 9 Category(ies) of Learning disability (8), Learning disability over registration, with number 65 years of age (1) of places Shaldon House DS0000026554.V255221.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate one named person with Physical Disabilty (PD). Will revert to 9 LD when named person leaves. 7th December 2004 Date of last inspection Brief Description of the Service: Shaldon House is operated by Parkcare No 2 Ltd a subsidiary of Craegmoor Healthcare. The home is situated in a residential area close to amenities and bus routes. A rear garden, which is reached by steps, has a grassed area and patio with seating. The home provides single bedroom accommodation, two of which are on the ground floor. Shaldon House DS0000026554.V255221.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over five hours. The manager was present during most of the inspection and was assisted by the deputy manager. Four residents were spoken with and all residents were observed. The atmosphere was homely and residents were relaxed and said they were happy at the home. A number of records were reviewed and tour of the building and garden area was made. What the service does well: What has improved since the last inspection? The manager has worked hard to ensure that a significant number of environmental requirements and recommendations from the last inspection have been resolved. Key training has also been provided to staff. Shaldon House DS0000026554.V255221.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. Shaldon House DS0000026554.V255221.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Shaldon House DS0000026554.V255221.R01.S.doc Version 5.0 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 the following standard(s): 2 Resident’s needs are assessed to ensure the home is suitable to meet individual requirements. EVIDENCE: The home has an established group of residents. One file reviewed showed needs had been assessed. The manager is fairly new to post and since there have been no recent admissions to the home this standard has not been fully assessed. Helpful discussions took place about future admission practice and the manager talked about trial visits and assessments that would be made prior to a future admission. Shaldon House DS0000026554.V255221.R01.S.doc Version 5.0 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 the following standard(s): 6, 9 Care planning is at a basic level and needs developing to support residents in improving the quality of their lives. No real evidence was seen to indicate that residents are supported to take risks as part of an independent lifestyle and this aspect of care practice needs to be enhanced. EVIDENCE: Four residents knew they had a key worker and two residents were able to indicate that their wishes were written down and in a care plan. They were also able to say that they spend time with their key worker talking about their needs. Two care plans and files with information about day-to-day care were reviewed containing basic information and tended to be repetitive, with limited detail. Care plans need to be brought to life with information that will help staff have the clarity to improve residents lives, including short medium and long-term goals. Shaldon House DS0000026554.V255221.R01.S.doc Version 5.0 Page 10 The files were well organised, but both the manager and inspector considered the current system to be cumbersome and difficult for staff to work with. The manager was seen to be working hard to comply with previous CSCI and provider guidance on this standard and whilst there is nothing wrong with the current system, if it results in limited quality recording, then the inspector agrees with the manager that a further change should be implemented. The current system is good in that it does cover key aspects of care and so any changes will need to be carefully made and the approach frequently reviewed. Whilst it is essential to keep residents safe, it is important for residents to be supported to take risks as part of an independent lifestyle. This standard will need a lot of work and will link in to care planning and the points mentioned above. At the next inspection it will be expected that more evidence will be available to show the small but important steps residents are taking. A recommendation will be made that training will be sought to support staff understanding of risk taking and care planning. Shaldon House DS0000026554.V255221.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 17 Residents enjoy a range of activity, which they enjoy. The lack of drivers limits the ability for residents to enjoy trips out. A menu was seen to provide a healthy diet. EVIDENCE: Three residents talked about activities they enjoy which included watching football, the recent holiday, a local day centre and college. Two residents specifically talked about the church they attend and how they enjoy it and one resident said it was the most important part of his/her life. A good activities record is maintained, including imaginative sessions, such as the ‘ pampering night’. Residents had enjoyed their recent holiday and it is most unfortunate the member of staff who had responsibility for taking photographs has left the home, failing to have the film processed. Since these memories are important it would be good if this matter could be explored further. Shaldon House DS0000026554.V255221.R01.S.doc Version 5.0 Page 12 None of the residents said they go out from the home on their own and three residents said they feel safe at the home or out with staff. One resident has a friend who visits the home and was seen on the day of inspection. The mainly young staff team, are not insured to drive the mini bus which the home has. This is very limiting for residents and a recommendation will be made to seek ways of providing drivers to take residents out and make good use of this valuable asset and important activity. Residents said they enjoyed meals and talked about staff that are good cooks. The menu showed that a healthy diet is provided. Shaldon House DS0000026554.V255221.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 Residents are content with their care. Further development of individual residents care plans and reviews is needed to ensure physical, emotional and health needs are well recorded. Further training concerning privacy will help to protect residents’ dignity. EVIDENCE: Four residents spoke of being happy with the care they receive. One resident said staff are good company and another that they like them all. Various records showed evidence that residents physical and health needs are met. The home has a number of records and books to record key information and these included: a diary daybook; daily entries book; weekly night check record; communications book. These records were up to date although the waking night check had last been completed on 04/10/05. It is considered that the number of different records and the different sections needing completion in resident’s files may be too complex for busy staff to complete. They could lead to a lack of accuracy and detail helpful in promoting the well being of residents. It will be recommended that these records, which are all important, should be reviewed along with the individual resident care files to see if improvements can be made. Shaldon House DS0000026554.V255221.R01.S.doc Version 5.0 Page 14 It is important that residents can be encouraged to be involved in the reviews of their care to ensure their needs are met. Currently residents do not wish to attend. The manager said this would be discussed again in January when each resident has his or her annual review. It should be remembered that the standard considers that reviews, involving other people and agencies significant to the resident should be undertaken at least every six months. The manager said that each resident has a key worker who completes a monthly review with the resident being involved. Two reviews were seen but there was no signature of the resident. These reviews are important and will support the main reviews. Whilst making a tour of the building a member of staff did not knock on a residents’ door and this may have caused loss of privacy and dignity for the resident in their room. A recommendation will be made to provide staff with training or supervision concerning this aspect. It should be noted that when staff are under pressure, normal practice can be forgotten momentarily and staff may need support in doing certain things automatically. Without embarrassing a specific member of staff, when points of poor practice are noticed, it can be helpful to look at the issues with the staff team. If a member of staff thinks they have done something very wrong, they need to know that we all make mistakes and it is important to be open to positive criticism and learn from it. Shaldon House DS0000026554.V255221.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Residents are protected by the homes policy and procedures. EVIDENCE: Three residents said they are listened to and they could talk to staff if they had a concern. The home has good policy and procedures and staff have had recent training concerning the protection of vulnerable adults and the manager is arranging further training in March for new staff. Shaldon House DS0000026554.V255221.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 The environment provided for residents is mainly good. Difficulties concerning local youths may have an effect on residents and support should be sought with works completed to a wall, which has been damaged. EVIDENCE: Shaldon House is very homely and residents said they were happy with their rooms, however damage to sinks has made them unsightly and a recommendation will be made that the problem is resolved or they are replaced. The home was clean and hygienic with no offensive smell. The manager has done well to ensure a significant number of requirements and recommendations from the last inspection have been actioned. A difficulty concerning the size of a radiator cover for bedroom 6 needs to be addressed to ensure a cover is fitted and a requirement will be made concerning this. A resident who adjusts a hot water valve making the water cold, needs support to help with the adjustment. Shaldon House DS0000026554.V255221.R01.S.doc Version 5.0 Page 17 The wall to the front and a part of the side of the property has been badly damaged by local youths who sit on it and break away rendering. Pieces of rendering were seen on the pavement and steps to the front garden and a gatepost was leaning over. Two heavy flat capping stones have worked free and could fall causing injury to residents or the public. It appears that the design of the wall makes it a convenient place for local youths to meet and sit. Potentially this could take away privacy for residents and may cause distress. It is likely that this will be a difficult problem for the manager to address and she will need support. It will be required that the wall be made safe and a recommendation will be made to seek guidance from the local community police officer to consider best options to resolve the problem. It was also noticed that the boundary fence with the adjoining property has a concrete post with a top section dangling from a metal rod. It is understood that the boundary belongs to the home and since this is unsightly and could cause an accident, it should be replaced. Shaldon House DS0000026554.V255221.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 Staff shortages have been resolved, ensuring staff are not tired when working with residents. The lack of staff qualified to NVQ Level 2 does not help development of practice. The home has a good recruitment system. EVIDENCE: At the start of the inspection one member of staff was caring for three residents, which was considered to be satisfactory and staffing increased as residents returned to the home to three care assistants. One member of staff said that recently they had two days off duty within a three-week period and a member of staff had worked for six days before having a day off duty. The situation had been mainly caused by the need for two staff at night including one awake to care for a resident. A member of staff has been helping out from another home, which was fully staffed and two staff have recently been appointed. By the time of the inspection the difficulties had been overcome. A recommendation will be made to consider ways of ensuring additional staff can be employed so that staff do not work long hours without a break in the future. Shaldon House DS0000026554.V255221.R01.S.doc Version 5.0 Page 19 Currently only one member of staff holds an NVQ Level 2 qualification and four staff are undertaking the training. This does not meet the standard of 50 and a recommendation will be made to support and encourage staff to undertake and complete their training. It is acknowledged that staff at this home have had great difficulty with their training provider in that there have been frequent changes of assessors for individual staff and this has had a significant impact on the ability of staff to move their work forward. One member of staff should be commended for seeking to gain NVQ level 3 and the deputy manager is undertaking the registered managers award; the new manager is also due to start this course soon which is a positive step and will provided good support as she works to develop practice at the home. Staff were observed providing sensitive care, which was appreciated by residents. Shaldon House DS0000026554.V255221.R01.S.doc Version 5.0 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 Records are in place but need to be developed to ensure residents can be confident their views underpin self-monitoring, review and development. EVIDENCE: A complaints/comments book is held on a hook in the communal/dining area and no comments have been recorded since 25/06/04. Residents have signed the residents meeting book and this was found to contain basic detail and needs bringing to life. The questionnaire for residents was seen and dated 24/02/05; it had no comments and needs to be developed. Shaldon House DS0000026554.V255221.R01.S.doc Version 5.0 Page 21 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 X 3 X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 2 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 2 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 2 X 3 X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Shaldon House Score 2 2 X X Standard No 37 38 39 40 41 42 43 Score X X 2 X X X X DS0000026554.V255221.R01.S.doc Version 5.0 Page 22 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 YA24 Regulation 23 Requirement Make the Capping stones to the front wall of the house safe and repair rendering so that it does not fall and be left to cause a risk to health and safety. Comply with this requirement by the time set or earlier if guided by insurance company or others. Provide a cover to a radiator in a residents’ bedroom where it has not been provided. (Previous timescale of 26/02/04 & 07/01/05 not met) Timescale for action 06/01/06 2 YA24 23 06/01/06 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 YA32 Good Practice Recommendations Provided staff with training on recording, care planning and risk taking so they can gain an understanding of how they can support residents to be more independent and have more choice in their lives. Replace or repair bedroom sinks that are badly stained. 2 YA24 Shaldon House DS0000026554.V255221.R01.S.doc Version 5.0 Page 23 3 YA24 4 5 6 7 8 YA39 YA32 YA32 YA14 YA6 Seek guidance from the local community police officer about the damage caused by youths sitting on the front wall of the home and about ways of dealing with the situation. Ensure resident’s views underpin all self-monitoring, review and development by the home. Support and encourage staff to complete their NVQ Level 2 qualification. Provide staff with training or supervision to ensure a good understanding of privacy and dignity and how this relates to the way residents are respected. Consider ways of providing additional drivers to increase opportunities for residents and enable trips out. Develop with the service user, their plan and risk assessments and monthly key worker reviews to ensure the depth of information has a positive impact on the quality of life and independence for residents, including short medium and long term goals. Shaldon House DS0000026554.V255221.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 Shaldon House DS0000026554.V255221.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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