CARE HOME ADULTS 18-65
Sheldon House 25 Church Street Oadby Leicestershire LE2 5DB Lead Inspector
Linda Clarke Unannounced Inspection 20th December 2005 10:30 Sheldon House DS0000062716.V271334.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 Sheldon House DS0000062716.V271334.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. Sheldon House DS0000062716.V271334.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Sheldon House Address 25 Church Street Oadby Leicestershire LE2 5DB 0116 2713520 0116 2711392 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) The SENAD Group Ms Deborah Lynn Kramer Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Sheldon House DS0000062716.V271334.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. No additional conditions of registration apply. Date of last inspection 21st September 2005 Brief Description of the Service: Sheldon House is a care home providing personal care and accommodation for upto 7 adults with a Learning Disability combined with difficult and challenging behaviour patterns. All bedrooms are single and with en-suite facilities consisting of a toilet and wash hand basin. The premise is owned by the SENAD Group Ltd. and is situated in the heart of Oadby, where local facilities and amenities can be found. Accommodation is provided over two floors, with communal areas, kitchens bathroom and bedroom facilities being on both floors. Sheldon House has a side courtyard garden, and a small rear garden, which is accessible to residents. Sheldon House DS0000062716.V271334.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 between 10.30am and 12.30pm. When undertaking Inspections, the Commission for Social Care Inspection focuses on the outcomes of individuals staying in the home. To support this, one resident was ‘case tracked’. This means that the care records and care plans of this resident were checked. The Shift Leader facilitated and contributed to the Inspection. What the service does well: What has improved since the last inspection? What they could do better:
Care plans need to be further developed to encompass in detail specialist techniques employed for the management of behaviour. The management processes should be open and transparent and record that they have been shared with relatives, and contracting/placing authorities. Staff need to be trained in a variety of techniques for the management of behaviour, which is reflective of individual resident needs, and ensures that residents are not placed at unnecessary risk.
Sheldon House DS0000062716.V271334.R01.S.doc Version 5.0 Page 6 Residents and their relatives need to be given opportunities to contribute and affect the development of the home, which includes their views as to the service offered, views should be published and made available and used to continually develop and improve the service. The submission of an action plan, following an inspection, by the Registered Person/Registered Manager of Sheldon House to the Commission for Social Care Inspection, would provide evidence that requirements and recommendations made were being considered. 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. Sheldon House DS0000062716.V271334.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 Sheldon House DS0000062716.V271334.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 and 5. The assessment process is well managed with information being provided, and residents having a comprehensive assessment of need undertaken. EVIDENCE: The admission process is adequate in that social care professionals carry out assessments of individuals, as part of the referral process. The records of one resident were viewed and was found to contain a comprehensive assessment undertaken by a Social Worker. Records of the resident also contained a contract between Sheldon House of the SENAD Group Ltd and the funding authority, which were signed by all parties. Sheldon House DS0000062716.V271334.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. Care planning is not effective in respect of challenging behavioural needs, which may lead to an inconsistent approach being adopted by staff. Residents are consulted on their care and encouraged to make choices about their lifestyles. EVIDENCE: The Inspector viewed the records of one of the three residents currently residing at Sheldon House. The previous inspection required that care plans were to be detailed in respect of behavioural techniques used, and evidence that the resident, relatives and funding authority were aware of the mechanisms adopted by staff in managing behaviour. No evidence was in place, which indicates that this has been addressed. The Shift Leader advised that staff have not received training in managing challenging behaviour, although some training has been planned for January 2006. This has the potential to put residents and staff at risk Sheldon House DS0000062716.V271334.R01.S.doc Version 5.0 Page 10 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): 11, 12, 14 and 15. Residents educational, recreational and leisure needs are met. EVIDENCE: Educational aspects are consistent with daily living skills, such as cooking and maintenance of the home, residents contribution to daily tasks is recorded as is their participation in recreational pursuits which include visits to local supermarkets, cinema, pub and walks into Oadby. A future trip to the Phoenix Theatre has been planned to see The Magic Roundabout, which is tailored to meet the assessed needs of individuals residing at Sheldon House. The resident whose file was viewed detailed that they recently attended two interviews for a place at College, it is hoped that they will be undertaking a course in computing. Residents have regular contact with relatives, visiting overnight and for weekends. Communication processes have been set up to ensure information between staff at Sheldon House and resident relatives is maintained. Residents will be visiting relatives and friends over the Christmas holidays.
Sheldon House DS0000062716.V271334.R01.S.doc Version 5.0 Page 11 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): EVIDENCE: Standards within this section were not inspected on this occasion. Sheldon House DS0000062716.V271334.R01.S.doc Version 5.0 Page 12 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): EVIDENCE: Standards within this section were not inspected on this occasion. Sheldon House DS0000062716.V271334.R01.S.doc Version 5.0 Page 13 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 and 28. The décor of the home is of a good standard providing a homely, comfortable and safe environment. EVIDENCE: The communal areas of the home, which includes a dining room, sitting room and kitchen on the ground floor were viewed, and were found to be in good decorative order, providing residents with a homely environment in which to relax. Residents have access to all parts of the home and garden. Sheldon House DS0000062716.V271334.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): 32 and 35. Staff are in receipt of training, however training specific to managing challenging behaviour has not taken place, which has the potential to put residents at risk. EVIDENCE: The shift leader was able to confirm that staff now receives a POVA first check as part of the recruitment process. A majority of staff have attained a level 2 qualification within the Learning Disability Award Framework; future planned training includes behavioural management techniques in January 2006, whilst shift leaders and the Registered Manager are to attend a course in Line Management. Staff have not received training in managing challenging behaviour, which is key to the care needs of individual residents, some training has been planned for January 2006. The needs of the residents indicate that a variety of techniques for managing behaviour are required, which cannot be met by one form of specialist training. The lack of relevant training has the potential to put residents and staff at risk Sheldon House DS0000062716.V271334.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 and 41. Current quality assurance systems are insufficient, and do not provide individuals with a formal opportunity to contribute and reflect upon the care they receive. EVIDENCE: The recommendation made at the previous inspection whereby the views expressed within resident meetings were shared within staff meetings could not be evidenced to having been implemented. Good practice should evidence that residents and staff are advised as to matters discussed within individual meetings, to ensure all parties are kept up to date with views and ideas expressed along with aspects relating to the day to day running of the home. The inspector viewed a record of the visits made by a manager of the SENAD group which evidences that Sheldon House is subject to unannounced visits which focus on staffing levels, presentation of the environment, financial checks and includes speaking with residents and staff, any action required is recorded. Sheldon House DS0000062716.V271334.R01.S.doc Version 5.0 Page 16 A mechanism for seeking the views of residents and their relatives and visiting professionals could not be evidenced; a formal system for seeking views should be put into place, which is used to continually develop the service offered by Sheldon House. The results of such surveys should be published and made available to relevant parties. A recommendation made at the previous inspection where by information pertaining to individual residents is recorded separately, consistent with Data Protection has been adopted. Sheldon House DS0000062716.V271334.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 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 3 Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X X X Standard No 24 25 26 27 28 29 30
STAFFING Score 3 X X X 3 X X LIFESTYLES Standard No Score 11 3 12 3 13 X 14 3 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 X X 2 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Sheldon House Score X X X X Standard No 37 38 39 40 41 42 43 Score X X 2 X 3 X X DS0000062716.V271334.R01.S.doc Version 5.0 Page 18 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 YA6 Regulation 15 Requirement Timescale for action 31/03/06 2. YA35 18 3. YA39 24 Care plans are to include detailed information as to behavioural techniques used, which is to be agreed by the resident, funding authority and relatives. The Registered Person to ensure 31/03/05 that all staff undertake training in techniques for the management of behaviour that is appropriate to the individual needs of residents. The Registered Person to 31/03/05 develop a quality assurance system which seeks the to views of residents and their relatives, and is used to continually develop the service. . 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 YA39 Good Practice Recommendations It is recommended that issues raised by residents and staff
DS0000062716.V271334.R01.S.doc Version 5.0 Page 19 Sheldon House in their individual meetings are acknowledged and shared. Sheldon House DS0000062716.V271334.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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