Inspection on 21/06/05 for Shandford

This inspection was carried out on 21st June 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Shandford 22/07/08

Shandford 05/10/06

Shandford 23/11/05

Shandford 02/02/05

Shandford 12/10/04

Shandford 26/01/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Shandford 31 Station Road Budleigh Salterton Devon EX9 6RS Lead Inspector Teresa Anderson Announced 21 June 2005 10:00 hrs The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Shandford D54 D06 S22028 Shandford V224458 210605 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Shandford Address 31 Station Road Budleigh Salterton Devon EX9 6RS 01395 443326 01395 443326 becky@shandford.wanadoo.co.uk www. shandford.com Shandford Residential Care Home Ltd Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Care Home 25 Category(ies) of OP Old age (25) registration, with number of places Shandford D54 D06 S22028 Shandford V224458 210605 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 2nd February 2005 Brief Description of the Service: Shandford Care Home is a large detached property in the coastal town of Budleigh Salterton. It is owned by a not-for-profit organisation and is overseen by a committee. Personal care and accomodation is provided for up to 25 residents who have needs relating to old age. The home is situated within pleasant and level gardens approximately one mile walk from the sea front and town centre. There is a 6-person passenger lift and ample parking is available. Shandford has been extensively modernised and extended since it was first acquired in 1958. It has recently undergone further improvements to extend the lounge and dining room and to add a treatment room and 2 ensuite bedrooms. Further improvements are planned. Shandford D54 D06 S22028 Shandford V224458 210605 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place as part of the normal programme of inspection between 10.00am and 3.30pm. The inspector met with or spoke with approximately 15 residents, the manager, the administrator and 5 members of staff. She saw the entire home and looked at records in relation to recruitment, assessment, care planning, residents monies and staff training. The home completed a preinspection questionnaire. No comments cards from residents or their families were received by CSCI. What the service does well: Residents say that Shandford provides high standards of assessment and care and this was confirmed at this inspection. Staff aim to care for residents for life. However, staff recognise that at times residents benefit from care in more specialist nursing environments. The current group of residents, whilst cared for as individuals, have similar dependency levels enabling residents to form a community and establish links and friendships. Care planning continues to improve and individual risk assessments are being developed. Residents say they are cared for with respect and in ways that they prefer and which meet their needs. Residents really enjoy living at Shandford and are relaxed and happy. They said ‘we are blessed’, ‘it couldn’t be better’ and ‘staff are superb’. Residents had no complaints and no complaints have been received since the last inspection. Residents feel safe and secure and were clear that if they were not happy for themselves, or for less able residents, they would speak with the manager or a carer. Staff are well trained and supervised. The numbers of staff on duty meet the residents’ care and social needs. In addition there are adequate domestic and catering staff. Volunteers assist with non-care duties. The home places a high emphasis on residents’ safety and as such carries out Criminal Record Bureau checks on all staff and volunteers and on visiting practitioners such as the chiropodist, the hairdresser and the management committee. The home is clean and hygienic throughout with good working practices that protect residents’ health, safety and welfare. Shandford D54 D06 S22028 Shandford V224458 210605 stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? 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. Shandford D54 D06 S22028 Shandford V224458 210605 stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Shandford D54 D06 S22028 Shandford V224458 210605 stage 4.doc Version 1.30 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 standard(s) 1, 3 and 5. Staff complete comprehensive preadmission assessments which ensure that residents admitted to Shandford have their needs fully assessed. People who use the service receive clear information to enable them to make a choice about whether or not they might wish to live at this home. EVIDENCE: Information available to residents is contained within a comprehensive guide which is frequently updated. More recently Shandford has developed a website which includes photographs and direct links to reports published by CSCI and to the CSCI website. Preadmission assessments demonstrate that great care is taken to ensure that the care and social needs of potential residents are identified before the home agrees to admit a resident. The manager talked of the importance of ensuring that the dependency and needs of residents could be matched to staffing skills and numbers, and matched to other residents living in the home. Staff training and supervision demonstrate that learning needs are identified and met in relation to residents’ care needs. Shandford D54 D06 S22028 Shandford V224458 210605 stage 4.doc Version 1.30 Page 9 Recently admitted residents said they had met with the manager prior to admission and that they, or a representative, had visited the home prior to making a decision about where to live. All felt that information was adequate and were happy with the choice they had made. Some residents talked of the friendships they had developed with other residents with whom they visited or chatted. Shandford D54 D06 S22028 Shandford V224458 210605 stage 4.doc Version 1.30 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 standard(s) 7, 8, 9 and 10. Good systems are in place to ensure that the health and personal care needs of residents are identified and met. The systems for the administration of medication are compromised by one area of poor practice. Residents are respected as individuals by staff who ensure that their rights to privacy are upheld. EVIDENCE: Care plans are comprehensive and continue to improve. The manager and staff have made some really good additions to the style of documentation used and these records are kept under review and up to date. Staff were clear about what residents’ needs and preferences are and how these should be met. Appropriate referrals to health care professionals are made. Sometimes this involves taking specialist advice and support and occasionally residents are assisted to find a home that can meet their changing and developing needs. One resident talked of how their health had improved with the help and interventions of staff. Shandford D54 D06 S22028 Shandford V224458 210605 stage 4.doc Version 1.30 Page 11 Changes have been made to the medication policies that have improved how staff handle medication and therefore the protection offered to residents. However, other practices need improvement. Some prescription only medications are being shared. Some residents prefer staff to dispense their medication but wish to take this at their leisure. Risk assessments should be carried out, actions taken to minimise associated risks and records demonstrate who dispensed and who administered medication when this differs. Shandford D54 D06 S22028 Shandford V224458 210605 stage 4.doc Version 1.30 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 standard(s) 15 General dietary needs of residents are well catered for. However, residents who require diabetic diets do not have enough choice. EVIDENCE: Residents talked of the ‘lovely food’ and ‘good food’. They talked of meals as social occasions when they could, if they chose, meet and chat with other residents. Some residents choose to have their meals in their bedrooms and said that the food was always hot and well presented. Food is well presented and there is variety and choice. The dining room is very pleasant and staff offer sensitive and discreet assistance as required. On this very hot summers day, jugs of juice were available throughout the home and residents were encouraged or reminded to drink. Residents who require diabetic diets do not always receive the food of their choice or the degree of variety available to other residents. The cook said she has not received training in cooking for diabetics and does not have a cook book relevant to this issue easily available. The kitchen is well managed and clean. Shandford D54 D06 S22028 Shandford V224458 210605 stage 4.doc Version 1.30 Page 13 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 standard(s) 16 and 18. A robust complaints procedure protects residents. Residents are not fully protected due to a lack of training for some staff. EVIDENCE: Shandford has a complaints policy detailing how complaints can be made. No complaints have been received since the last inspection. Residents said they had no complaints at all about Shandford. They said that if they did, they would tell the manager or a carer. Residents were obviously comfortable in the company of staff and said how they felt safe and secure. Care staff have a good knowledge of issues relevant to the protection of vulnerable adults. However, housekeeping staff have not all received this training and advice available to staff in a handbook is contrary to guidance issued by the Department of Health. In addition domestic staff said that they sometimes find it difficult to deal with residents whose behaviour challenges the service. The manager confirmed they had not received training. Shandford D54 D06 S22028 Shandford V224458 210605 stage 4.doc Version 1.30 Page 14 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 standard(s) 19 and 26. Residents live in a comfortable environment that is being progressively upgraded and which is safe and clean throughout. EVIDENCE: Shandford is a home which has been refurbished and extended over the years. The downstairs lounge is divided into several seating areas and residents talked about how they like it. There is another lounge on the first floor which current residents say they tend not to use. The newer bedrooms are large and have ensuite facilities. Older rooms are smaller but the residents say they are happy with them. The guide to the home details all room sizes so prospective residents can be clear regarding the size of the bedroom available. The majority of residents talked about how they enjoyed the gardens. There are at least two domestic staff on duty everyday who keep the home clean throughout. A scheme has recently been introduced that ensures that all rooms receive a thorough ‘spring clean’ on a rolling rota basis. Shandford D54 D06 S22028 Shandford V224458 210605 stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30. Residents are protected and benefit from the homes recruitment policy and a well-trained, skilled and experienced staff group. Residents benefit from a group of committed volunteers. EVIDENCE: Without fail, all residents were complimentary about staff, who described them as ‘lovely’, ‘super and ‘fabulous’. They said they were always patient and able to help them. Residents were relaxed in their company, knew their names and said they are ‘friends who help’. In general, there are four care staff on duty in the morning, three care staff in the afternoon and two at night. In addition there is a manager and deputy manager on duty on most weekdays, a day cook and supper cook, a kitchen assistant and two cleaners. In addition volunteers undertake non-care duties such as shopping and taking residents out. During the past few weeks the home have had cause to cover a number of duties using agency staff. Residents say that although ‘they are not the same they were OK’. Records show that where possible, the same agency staff were used to promote continuity and knowledge. Staff training is comprehensive. All staff receive induction training and almost 50 of staff are NVQ trained. Other training has included the administration of Shandford D54 D06 S22028 Shandford V224458 210605 stage 4.doc Version 1.30 Page 16 medicines, care of people with diabetes, first aid, abuse awareness training and infection control. All staff, including the chiropodist, volunteers, hairdresser and management committee members undergo checks including criminal record bureau checks in order to help protect residents. Shandford D54 D06 S22028 Shandford V224458 210605 stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 35 and 38. The residents who live at Shandford benefit from the expertise of a manager who is competent and experienced and has demonstrated sound leadership skills. Resident’s views are sought and acted upon. Residents’ monies and their possessions are protected by good systems of management and working practices. EVIDENCE: The current manager has worked at Shandford since September 2004. During that time she has demonstrated her ability to manage a busy care home and introduced many new systems, improved communication and training and has positively contributed to the levels of satisfaction experienced by residents. The system for managing residents’ monies is safe and secure. It is easily auditable and residents said the system is easy to use and suits them. Shandford D54 D06 S22028 Shandford V224458 210605 stage 4.doc Version 1.30 Page 18 Staff receive mandatory induction training together with training in moving and handling, fire safety, first aid, food hygiene and infection control. Safe working practices and maintenance and checking systems are in operation and are sound. Fire checks and controls are satisfactory. Shandford D54 D06 S22028 Shandford V224458 210605 stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 4 x 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 2 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 4 28 x 29 4 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 3 3 x x 3 x x 3 Shandford D54 D06 S22028 Shandford V224458 210605 stage 4.doc Version 1.30 Page 20 No 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 9 Regulation 13(2) Requirement The registered person must make suitable arrangements for the handling of medications. (This refers to the need to ensure that only bulk medicines are given to more than one resident; and that risk assessments and actions are recorded in relation to self medication). Timescale for action 30/06/05 2. 18 13(6) The registered person must 30/09/05 ensure that all staff receive training in the protection of vulnerable adults and that advice given to staff complies with Department of Health guidance. 3. 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 15 Good Practice Recommendations The registered person should ensure that special diets for diabetics are provided. D54 D06 S22028 Shandford V224458 210605 stage 4.doc Version 1.30 Page 21 Shandford 2. 3. 4. 5. 6. Shandford D54 D06 S22028 Shandford V224458 210605 stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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 Shandford D54 D06 S22028 Shandford V224458 210605 stage 4.doc Version 1.30 Page 23 - 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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