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Inspection on 02/11/05 for Burgess Care Limited

Also see our care home review for Burgess Care Limited for more information

This inspection was carried out on 2nd November 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 found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

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

What the care home does well

The service continues to provide a safe, friendly and relatively unrestricted home in which residents are helped to develop living skills and focus on the positive, rather than the negative side, of their lives. Staff continue to be enthusiastic about the progress made by people living at the home, particularly those who are relatively recent admissions. There continue to be a wide variety of activities available, enabled and supported by the home.

What has improved since the last inspection?

Previous environmental requirements have been met. New residents are settling in well in the Meadows.

What the care home could do better:

The home has been through a difficult period recently, with the death of two residents, and with two other residents being admitted to hospital. The manager acknowledged that this has slowed down progress in areas such as regular staff supervision, and the full development of personal plans in userfriendly formats, one of which was seen in the form of a communication diary, with plenty of photographs and clear straight forward captions. The home should review the application of its `No Restraint policy`, with outside advice as necessary, focusing on how this should apply in response to individual circumstances.

CARE HOME ADULTS 18-65 Sharmer Fields House Fosse Way Radford Semele Leamington Spa Warwickshire CV31 1XH Lead Inspector Martin Brown Unannounced Inspection 2nd November 2005 11:15a Sharmer Fields House DS0000004296.V262765.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 Sharmer Fields House DS0000004296.V262765.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. Sharmer Fields House DS0000004296.V262765.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Sharmer Fields House Address Fosse Way Radford Semele Leamington Spa Warwickshire CV31 1XH 01926 614048 01926 613048 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) Burgess Care Mrs Maxine Jane Forman Care Home 16 Category(ies) of Learning disability (16) registration, with number of places Sharmer Fields House DS0000004296.V262765.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. That Mrs Forman successfully completes the NVQ Registered Managers Award by 1 April 2006. NVQ Level 4 That Mrs Forman successfully completes the NVQ in Care at Level 4 (or whichever new title that the General Social Care Coucil may give to this award in its review of 2005) by 1 April 2006. That Mrs Forman notifies the Commission for Social Care Inspection if she fails to achieve these Awards or does not complete them for any reason. 6th July 2005 3. Date of last inspection Brief Description of the Service: Sharmer Fields’ registered premise consists of 3 five-bedded self-contained facilities. Each unit is individually identified as the Meadows, Sharmer Fields House and the Paddocks. Each unit is home for up to five people with learning disabilities. Burgess Care provides 24 hours support to the people living in the home. The home is set in a rural area, 300 yards off the Fosse Way at the end of a shared drive. There are extensive grounds to the property. Shared facilities in all units consist of a lounge, quiet room, kitchen and laundry. Shared facilities are on the ground floor of each unit; there are also office facilities in each unit. Available also is a converted stable, which offers day-care facilities for the service users. There are well-maintained lawns as well as an allotment area maintained with the assistance of the residents. Two of the units are not suitable for access by wheelchair users. However the provision of another five-bedded self-contained unit on the premises has full facilities to enable wheelchair access. Sharmer Fields House DS0000004296.V262765.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place during a Wednesday daytime and lasted for four hours. Staff and management were welcoming and helpful, and the majority of the service users were seen at some point in the inspection. All three ‘houses’ at the home were visited, although on this occasion, a large proportion of the time was spent in the Meadows, which is a relatively new service, with relatively recent admissions, one of whom has moved in since the last inspection. What the service does well: 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. Sharmer Fields House DS0000004296.V262765.R01.S.doc Version 5.0 Page 6 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 Sharmer Fields House DS0000004296.V262765.R01.S.doc Version 5.0 Page 7 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): EVIDENCE: These standards have previously been met or exceeded, and were not fully looked at on this occasion. It was noted that new admissions in the Meadows continue to take place in a carefully planned way, to ensure that they take place in ways and timescales most beneficial to existing and new residents. Sharmer Fields House DS0000004296.V262765.R01.S.doc Version 5.0 Page 8 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 Dating of all guidelines will help ensure they are all kept up-to-date. The development of ‘communication passports’ will help service users to ensure their needs and wishes are more readily addressed. EVIDENCE: Individual care plans, with risk assessments, and behavioural guidelines continue to be in place and to inform and support consistent staff responses to behaviours. Most risk assessments and guidelines were dated and evidenced regular reviews. One otherwise excellent concise ‘trigger’ guide to individual behaviours did not have a date or a named author. A Communication Passport was seen for one service user, staff advised that further ones were being planned. Sharmer Fields House DS0000004296.V262765.R01.S.doc Version 5.0 Page 9 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 continue to benefit from a variety of activities that take place outside the home, and from a varied and healthy diet. EVIDENCE: These standards were seen to be met during the previous inspection, and were not fully assessed on this occasion, other than to note that service users continue to take part in a wide variety of activities inside and outside the home. Day service support workers are employed to assist with this. Lunch was taken with two residents on the ‘Meadows’, who were encouraged to help with chores such as clearing away and drying up plates, as part of the development of personal skills. Sharmer Fields House DS0000004296.V262765.R01.S.doc Version 5.0 Page 10 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 Service users currently observed at the home receive personal support in a way they prefer and require. In the light of a recent hospital admission, the home is recommended to review the ‘no restraint’ policy, with specialist advice on its application in individual circumstances, and the implication for future admissions. EVIDENCE: These standards were met at the previous inspection. The positive support offered by staff to service users during the course of the inspection, was noted, as were the overwhelmingly positive comments received in this respect by relatives prior to the inspection. The home continues to operate a ‘No Restraint’ policy; a copy of this was seen. One service user has been compulsorily admitted to hospital and, prior to the inspection, was re-admitted to the home unsuccessfully for a short period. In this instance, ‘no restraint’ meant allowing him access to beverages, including other people’s. Sharmer Fields House DS0000004296.V262765.R01.S.doc Version 5.0 Page 11 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 The home is addressing concerns that a relative is not kept fully informed regarding their son’s well-being. A policy clarifying the use of the Paddocks lounge at night would ensure this is not detrimental to the service users. EVIDENCE: These standards were seen to be met at the previous inspection, and were not fully assessed on this occasion. Comment cards were received prior to the inspection; the majority were very positive. Where there was a question of ensuring that relatives are kept fully informed of their son’s well-being, the home was able to confirm that communication had been re-instated on a more regular basis via a named keyworker. The lounge in the Paddocks is used by staff who are sleeping in. A sofa bed is used, that is unobtrusive and part of the day-to-day lounge furniture. Staff advised that this practice is not restrictive to access to the lounge, as residents do not tend to use it later in the evening, and that, were this the case, alternative rooms in other parts of the complex, are available. Staff were unaware of any policy guidelines confirming these arrangements. Sharmer Fields House DS0000004296.V262765.R01.S.doc Version 5.0 Page 12 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): 24,25 The home is well-furnished and well-maintained. Maintenance procedures are able to keep on top of wear ad tear to the fabric of the building. A tumble dryer may be of benefit in wet weather, in the Paddocks. The home needs to ensure that, while service user wishes are respected, activities that compromise their privacy and dignity are responded to appropriately. EVIDENCE: Previous environmental requirements had been made good; all parts of the home seen were in good repair. The lounge of the Paddocks was pleasantly furnished and homely, but there were damp clothes drying on radiators. The drive leading into the home is potholed and uneven. The manager advised that this drive is not solely owned by Burgess Care, as access is shared with a neighbour. Sharmer Fields House DS0000004296.V262765.R01.S.doc Version 5.0 Page 13 Bedrooms in the Meadows were looked at and seen to be spacious and to reflect individual taste. One resident’s cupboard door had been removed. Staff advised that this was done by the person themselves wishing to have easier access to clothes. The curtains were also removed; again, by the person living in that room. Sharmer Fields House DS0000004296.V262765.R01.S.doc Version 5.0 Page 14 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): 36 Regular supervision will help staff development. EVIDENCE: The key standards were met at the last inspection. Staff on duty during the inspection, supported by day service staff, were able to meet the needs of service users. There has been a number of new staff, following the departure of a number of staff for varied, and valid reasons, explained by the manager. Staff supervision and staff appraisals have been taking place less frequently than the National Minimum Standards require. The manager advised that the new management that had been introduced, with a deputy manager in each ‘unit’, will ensure that bi-monthly supervision, and annual appraisals, will now take place. Sharmer Fields House DS0000004296.V262765.R01.S.doc Version 5.0 Page 15 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): 39,42. There appears to be a disparity of views between relatives and the home over the availability of inspection reports. The health and safety of service users are promoted and protected. EVIDENCE: It was noted on a number of responses from relatives that they were not aware of inspection reports. Staff and management advised that these were made available in the home. Requirements from the previous inspection in this section have been actioned. Observation, pre-inspection information, and examination of maintenance reports show that the home continues to be safe and well-maintained. Sharmer Fields House DS0000004296.V262765.R01.S.doc Version 5.0 Page 16 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 X X X X Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 X X X X X LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X X X X 2 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Sharmer Fields House Score 3 X x x Standard No 37 38 39 40 41 42 43 Score X X 3 X X 3 x DS0000004296.V262765.R01.S.doc Version 5.0 Page 17 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 2 Standard YA9 YA23 Regulation 13(4) 12(4) Requirement All behavioural guidelines must be dated, to facilitate regular reviews and updating. A sleeping-in policy must clarify the use of the Paddocks lounge for this purpose, and identify alternatives if this becomes problematic for service users. Staff supervision and appraisals must take place within minimum timescales. Timescale for action 12/12/05 12/12/05 3 YA36 18(2) 12/12/05 Sharmer Fields House DS0000004296.V262765.R01.S.doc Version 5.0 Page 18 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 2 3 Refer to Standard YA24 YA24 YA39 Good Practice Recommendations It is recommended that the Paddocks laundry has a tumble dryer. The home should seek to have the driveway permanently in a good state of repair. The home should seek to ensure that relatives are better aware of inspection reports and of how to contact the Commission for Social Care Inspection. The home is recommended to review the ‘no restraint’ policy, with specialist advice on its application in individual circumstances, and the implication for future admissions. The home should continue with strategies to ensure that curtains remain in place in bedrooms. 4 YA18 5 YA24 Sharmer Fields House DS0000004296.V262765.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB 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 Sharmer Fields House DS0000004296.V262765.R01.S.doc Version 5.0 Page 20 - 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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