CARE HOMES FOR OLDER PEOPLE
Shandford 31 Station Road Budleigh Salterton Devon EX9 6RS Lead Inspector
Teresa Anderson Unannounced Inspection 23rd November 2005 10:30 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 Shandford DS0000022028.V259350.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. Shandford DS0000022028.V259350.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Shandford Address 31 Station Road Budleigh Salterton Devon EX9 6RS 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) 01395 443326 becky@shandford.wanadoo.co.uk www.shandford.com Shandford Residential Care Home Limited Miss Susan Marie Bissett Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Shandford DS0000022028.V259350.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 21st June 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 voluntary committee. Personal care and accommodation 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 DS0000022028.V259350.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place as part of the normal programme of inspection. This is the second inspection this year and this report should be read in conjunction with the report produced following the inspection in June. During this inspection, the inspector spoke with staff, with the administrator, with the manager and with approximately seven residents. She saw all the communal areas and some bedrooms. Records in relation to care planning and risk assessment were inspected. What the service does well:
A number of planned activities take place at Shandford on a regular basis. These include bingo, quizzes, music and sing-a-longs, crosswords, poetry readings and movement to music. External activities include trips out to the local pub, walks into Budleigh and taking part in the local community activities. This will include attending the local Christmas sale at the village hall. In addition, the local vicar comes to the home to take services. Residents choose whether or not they wish to be involved in any of these activities. Some enjoy the quizzes and they say the bingo and sing-a-long is very popular. On the day of inspection many residents were looking forward to the piano playing that had been arranged for that afternoon. Residents are very much involved in in-house activities for example in the recent celebration of the homes 47th birthday. One resident talked of how she had been invited to cut the cake, as she had lived at Shandford for the longest. This, and other events, are recorded in a photo album which is kept in the lounge for residents and staff to look at and share with their visitors. The home also has a resident budgerigar (Joey), which many residents talk to, a fish tank, TV, radio and a visiting seagull which residents are not encouraged to feed, but do. Care plans demonstrate that resident’s preferences are recorded. For example information includes what time each resident likes to get up, go to bed, what time they like breakfast and where they like to take this. All residents were very complimentary about the food saying ‘it is wonderful’, ‘it is always well cooked’ and ‘the cook knows I don’t drink so when she makes sherry trifle she always makes me a separate one without the sherry’. The dining room is well appointed, bright and cheerful and place residents say they like taking their meals. However, residents also said that if they wanted a meal on a tray in their room, this was not a problem ‘the staff can’t do enough’. Shandford DS0000022028.V259350.R01.S.doc Version 5.0 Page 6 At the last inspection it was noted that diabetics did not always get the same variety of diet due to dietary restrictions. At this inspection, residents said that this was no longer a problem. Since the last inspection the manager, Susan Bissett, has registered with CSCI. She has consistently demonstrated a sound knowledge base and has good experience of working with the physically disabled and with the elderly. She also has a positive attitude towards learning, and to gaining and passing on new information for the benefit of residents. 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 DS0000022028.V259350.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 Shandford DS0000022028.V259350.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): These standards were inspected and met or exceeded at the last inspection. EVIDENCE: It is worth mentioning that the Statement of Purpose has been updated since the last inspection and that CSCI were very promptly provided with a copy. Shandford DS0000022028.V259350.R01.S.doc Version 5.0 Page 9 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): 9 The system for administering medication protects residents from any errors or omissions. EVIDENCE: The medication system was inspected during the inspection in June. At that time it was noted that some ‘homely’ medications were being shared. This has since been remedied and residents all now have their own medicines. Shandford DS0000022028.V259350.R01.S.doc Version 5.0 Page 10 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 and 15. Residents’ lives are enriched through contact with the local community and the provision of activities and they are empowered to exercise control over their own lives. The meals provided are not only a source of nutrition but also something that enhances residents days. EVIDENCE: A number of planned activities take place at Shandford on a regular basis. These include bingo, quizzes, music and sing-a-longs, crosswords, poetry readings and movement to music. External activities include trips out to the local pub, walks into Budleigh and taking part in the local community activities. This will include attending the local Christmas sale at the village hall. In addition a fashion evening has been arranged and the manager is investigated if there is a local tea dance for more able to residents to attend. Residents choose whether or not they wish to be involved in any of these activities. Some enjoy the quizzes and they say the bingo and sing-a-long is very popular. On the day of inspection some residents had been out to church and many were looking forward to the piano playing which had been arranged for that afternoon. Residents are assisted to partake in activities by other residents, by members of the voluntary committee and by paid staff. They are very much involved in
Shandford DS0000022028.V259350.R01.S.doc Version 5.0 Page 11 in-house activities for example in the Christmas raffle (staff have donated all the prizes) and in the recent celebration of the homes 47th birthday. One resident talked of how she had been invited to cut the cake, as she had lived at Shandford for the longest. This, and other events, are recorded in a photo album which is kept in the lounge for residents and staff to look at and share with their visitors. The home also has a resident budgerigar (Joey) which many residents talk to, a fish tank, TV, radio and a visiting seagull which residents are not encouraged to feed, but do. The inspector and manager talked of how activities could easily become female biased and of how the Royal National Institute for the Blind might be able to help with activities for residents with poor sight (as well as possibly providing information/training for staff). Care plans demonstrate that resident’s preferences are recorded. For example information includes what time each resident likes to get up, go to bed, what time they like breakfast and where they like to take this. All residents were very complimentary about the food saying ‘it is wonderful’, ‘it is always well cooked’ and ‘the cook knows I don’t drink so when she makes sherry trifle she always makes me a separate one without the sherry’. The dining room is well appointed, bright and cheerful and a place residents say they like taking their meals. However, residents also said that if they wanted a meal on a tray in their room, this was not a problem ‘the staff can’t do enough’. At the last inspection it was noted that diabetics did not always get the same variety of diet due to dietary restrictions. At this inspection, residents said that this was no longer a problem. Shandford DS0000022028.V259350.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): 18. Residents are protected from abuse. EVIDENCE: At the last inspection it was noted that although staff had a good understanding of what constitutes abuse and demonstrated a ‘zero tolerance’ to it, there was some contradictions in policy. Since then, the manager has provided further training and reviewed internal policies. Staff have a good understanding of what to do if they suspect abuse or if an allegation/disclosure is made. Residents clearly have very comfortable relationships with the staff. They say they feel safe and well looked after. Comments include ‘staff are wonderful to me’, ‘I feel very well cared for here’ and ‘so much is done for you’. Shandford DS0000022028.V259350.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): These standards were met at the last inspection. EVIDENCE: Shandford DS0000022028.V259350.R01.S.doc Version 5.0 Page 14 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): These standards were met or exceeded at the last inspection. EVIDENCE: Shandford DS0000022028.V259350.R01.S.doc Version 5.0 Page 15 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 and 38 Residents’ lives are enhanced through the experience and skills of the current Registered Manager. Resident’s safety could be better protected through improved risk assessments and actions in relation to fire safety. EVIDENCE: Since the last inspection the manager, Susan Bissett, has registered with CSCI. She has consistently demonstrated a sound knowledge base and has good experience of working with the physically disabled and with the elderly. She also has a positive attitude towards learning, and to gaining and passing on new information for the benefit of residents. On this occasion it was noted that an area under the stairs is being used for storage. Whilst the amount stored on this occasion was not excessive, it is wise to try and keep these areas ‘sterile’ for fire safety reasons. The home does comply with fire regulations, but it is always worth carrying our risk
Shandford DS0000022028.V259350.R01.S.doc Version 5.0 Page 16 assessments on high risk areas and ensuring staff are aware of and comply with any agreed actions. This applies to all areas of the home but in particular on this occasion the area mentioned and room 14, which is used for storing combustible materials. Shandford DS0000022028.V259350.R01.S.doc Version 5.0 Page 17 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 x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 3 x x x x x x x x STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x x x x x x 2 Shandford DS0000022028.V259350.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? No 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 OP38 Regulation 23(4) Requirement The registered person must ensure that adequate precautions are taken against the risk of fire. (This relates to the need to ensure that risk assessments are undertaken, are up to date, regularly reviewed and staff adhere to agreed actions; and to the need to keep areas below staircases as ‘sterile’ as possible. Timescale for action 24/12/05 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 Shandford DS0000022028.V259350.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Exeter 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
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