CARE HOMES FOR OLDER PEOPLE
Sheldon Lodge 150 Sheldon Road Chippenham Wiltshire SN14 0BZ Lead Inspector
Thomas Webber Unannounced Inspection 23 February 2006 11:55 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 Sheldon Lodge DS0000028697.V283661.R01.S.doc Version 5.1 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. Sheldon Lodge DS0000028697.V283661.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Sheldon Lodge Address 150 Sheldon Road Chippenham Wiltshire SN14 0BZ 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) 01249 660001 Mr Sateeam Arithoppah Mrs Jayne Arithoppah Care Home 9 Category(ies) of Dementia - over 65 years of age (2), Old age, registration, with number not falling within any other category (9) of places Sheldon Lodge DS0000028697.V283661.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. Training in dementia care is provided to all staff on a regular basis. This is to be evidenced within individual staff training files. A record of service users night time needs must be maintained . Night staffing must be reviewed in response to any change in the assessment needs of those service users with dementia. Appropriate action must be taken in response to the users changing needs, which may include the provision of night staff. 15th September 2005 Date of last inspection Brief Description of the Service: Sheldon Lodge is registered to care for nine older people, two of whom may have dementia or associated illnesses. The home also has two beds available for referrals from the local intermediate care team. Sheldon Lodge is a detached property which is located within a residential area of Chippenham and is within close proximity to a public house and convenience store. The home is privately owned and the proprietors are Mr and Mrs Arithoppah who live on the premises and undertake many shifts as part of the working care roster. The home offers five single and two shared bedrooms which are located on the ground and first floor and a stair lift is installed to access all parts of the building. Sheldon Lodge DS0000028697.V283661.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection, undertaken during the course of one day from 11:55 to 15:45. The inspection primarily focused on the direct care provided to the residents and the views of all nine residents were sought on an individual or group basis. Standards assessed during this inspection included residents’ privacy, dignity and choice, food menus, complaints, staffing levels and training, residents’ finances and quality assurance. A tour of the premises was also undertaken. What the service does well:
The home continues to provide sufficient numbers of staff on duty at all times and continues to work well towards achieving a trained workforce. Residents spoken to during the course of the inspection confirmed that they were very happy with the care and support provided by the staff. Residents stated that they are well cared for and the staff are very kind. Some residents described the home as being a home from home. Residents live in a homely and comfortable environment, which is well maintained and meets their individual and collective needs. Residents’ bedrooms/areas have been personalised to their individual wishes. Residents have access to safe, comfortable and suitably furnished and decorated communal facilities together with sufficient toilet shower and bathroom facilities. The home is maintained to a good standard being clean and tidy and provides suitable laundry facilities. Residents spoken to commented satisfaction with their level of private accommodation and confirmed that their bedrooms are kept clean and tidy. Residents also commented positively with the laundry arrangements in place and confirmed that their clothing is returned in good condition. Residents’ rights to privacy and dignity are upheld. Residents can also exercise personal autonomy and choice within their capabilities. Residents’ financial interests are safeguarded by either themselves or their families. Residents receive a varied and balanced diet and residents spoken to commented extremely positively about the quality and quantity of food provided. They confirmed that they received plenty of food. Information is provided to residents on how to complain should they wish to and the home has not received any complaints since the last inspection. Residents spoken to commented that they had no concerns or complaints about the care provided but they felt confident that they could discuss any issues with Mrs Arithoppah and staff and these would be listened to and suitably acted upon.
Sheldon Lodge DS0000028697.V283661.R01.S.doc Version 5.1 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. Sheldon Lodge DS0000028697.V283661.R01.S.doc Version 5.1 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 Sheldon Lodge DS0000028697.V283661.R01.S.doc Version 5.1 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): EVIDENCE: These Standards were not assessed during this inspection, as the core Standards 3 and 6 had been satisfactorily assessed at the previous inspection. However, Mrs Arithoppah was provided with a minor variation application form to complete and return to the Commission for Social Care Inspection as the two intermediate care beds need to be registered. Sheldon Lodge DS0000028697.V283661.R01.S.doc Version 5.1 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): 10 Residents’ rights to privacy and dignity are upheld. EVIDENCE: Observations and discussions with residents confirmed that the majority of them are provided with their own bedroom where they can conduct all their personal affairs in complete privacy, including medical examinations, any treatment and personal care. Locks are provided to residents’ bedroom doors and residents can also choose where to see their visitors. Residents have access to the home’s mobile phone, which can be used by them to make and receive telephone calls in the privacy of their bedrooms. Residents are not charged for any calls made unless they make a call to another mobile phone. Alternatively, residents can have a telephone installed in their bedrooms. Residents’ mail is given directly to them unopened. Sheldon Lodge DS0000028697.V283661.R01.S.doc Version 5.1 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): 14 and 15 Residents, within their capabilities, can exercise personal autonomy and choice and residents receive a varied and balanced diet. EVIDENCE: Observations and discussions with residents confirmed that they can exercise personal autonomy and choice within their capabilities. Residents can and have brought items of furniture and personal possessions to make their bedrooms more homely, they can choose how and where to spend their time, and what activities to participate in. However, there was a difference of opinion with regard to residents’ ability to choose when to get up and go to bed. The majority of residents confirmed that they can choose when to get up and go to bed and were happy with the routines of the home. However, one resident stated that she has to get up for breakfast and has to go to bed by 21:00, which coincides with the end of the evening shift worked by staff. In discussion with Mrs Arithoppah, she was clear that residents can choose when to go to bed, although she and a member of staff, separately spoken to, acknowledged that many of the residents tend to choose to go to bed early to watch their televisions. Mrs Arithoppah was advised of the need to reinforce the bedtime policy of the home, particularly, to those residents who are admitted for intermediate care as the negative comment may be one of perception.
Sheldon Lodge DS0000028697.V283661.R01.S.doc Version 5.1 Page 11 A satisfactory and varied four weekly menu is in operation, which provides a choice at breakfast and at teatime with the option of a cooked breakfast at weekends. The main meal of the day is held at lunchtime providing a set meal or the option of a vegetarian meal, although the latter is rarely taken up. Supper is made available for residents and this is served at about 19:30. Mrs Arithoppah continues to undertake the majority of the cooking duties. Drinks and snacks are available at other set times of the day. Mealtimes are flexible to take into account residents’ appointments and this was evident during the inspection. Mrs Arithoppah reported that residents are encouraged and tend to use the dining room to eat their meals, although residents could to choose to eat their meals in their bedrooms if they wished. Residents spoken to commented extremely positively about the quality and quantity of food provided and they confirmed that they receive plenty of food. Sheldon Lodge DS0000028697.V283661.R01.S.doc Version 5.1 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): 16 Information is provided to residents on how to complain should they wish to and residents felt confident that any concerns/complaints would be listened to and acted upon. EVIDENCE: The home has established a complaints procedure and all residents have been provided with a copy. Mrs Arithoppah reported that the home has not received any complaints since the last inspection. Residents spoken to commented that they had no concerns or complaints about the care provided but they felt confident that they could discuss any issues with the proprietor and staff and these would be listened to and suitably acted upon. Mrs Arithoppah reported that consultation is a natural process and any concerns would be addressed at an early stage. She sees the residents on a daily basis and meets with their relatives at least fortnightly. Sheldon Lodge DS0000028697.V283661.R01.S.doc Version 5.1 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): 19, 20, 21 and 24 Residents live in a homely and comfortable environment, which is suitably maintained and meets their individual and collective needs. Residents’ bedrooms/areas have been personalised to their individual wishes. Residents have access to safe, comfortable and suitably furnished and decorated communal facilities together with sufficient toilet shower and bathroom facilities. The home is maintained to a good standard being clean and tidy and provides suitable laundry facilities. EVIDENCE: The home continues to be maintained to a suitable standard being clean and tidy and provides sufficient light, heating and ventilation. Although the level of heating within the lounge appeared to be satisfactory, two of the residents spoken to were cold. This issue was raised with Mrs Arithoppah to look into. ‘Door guards’ have also been fitted to all doors on the ground floor so that they can be safely held open as required. Sheldon Lodge DS0000028697.V283661.R01.S.doc Version 5.1 Page 14 The communal areas consist of a lounge and a separate dining room. All areas are homely, comfortable and suitably maintained. At the front of the building there is a pleasant, well-maintained garden. The home provides suitable bath, shower and toilet facilities to meet the needs of the residents, although the shower facilities are reported by Mrs Arithoppah to be rarely used. The home provides five single and two shared bedrooms, which are located on the ground and first floor levels. A stair lift has been installed for residents to easily access both floors. Residents’ bedrooms are suitably furnished and equipped to ensure comfort and privacy. Residents can and have brought items of furniture and personal possessions to make them more homely. Locks have been fitted to residents’ bedroom doors. Residents spoken to stated that they were satisfied with their level of private accommodation and confirmed that their bedrooms are kept clean and tidy. Residents also commented positively about the laundry arrangements in place and confirmed that their clothing is returned in good condition. Sheldon Lodge DS0000028697.V283661.R01.S.doc Version 5.1 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 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): 27, 28 and 30 The home continues to provide sufficient numbers of staff on duty at all times, although the need for waking night staff will be monitored at subsequent inspections. The home continues to work well towards achieving a trained workforce. EVIDENCE: The home provides the minimum levels of staff, which comprises of two care staff on duty throughout the waking day and commences at 08:00 and finishes at 21:00. A cleaner is also being employed for five afternoons a week and an activities person and art therapist work in the home for a total of four afternoons per week. There are no waking night staff employed at night but Mr and Mrs Arithoppah provide the necessary sleeping in duties. Mrs Arithoppah reaffirmed that she or her husband makes regular checks during the night. All residents have access to a call bell and are encouraged to ring for assistance if required. The call would then be heard within Mr and Mrs Arithoppahs’ private accommodation. The previous inspection report required the home to ensure that all night time checks and intervention of residents’ needs are fully documented due to the unpredictability of older peoples’ health and the lack of waking night staff on duty within the home. Mrs Arithoppah continues to achieve this within the residents’ care plans, risk assessments documentation and within each resident’s daily record. Mrs Arithoppah confirmed her belief that currently there was no need to employ waking night staff for the residents
Sheldon Lodge DS0000028697.V283661.R01.S.doc Version 5.1 Page 16 accommodated but it was agreed that these arrangements would be reviewed at subsequent inspections. Residents spoken to during the course of the inspection confirmed that they were very happy with the care and support provided by the staff. Residents stated that they are well cared for and the staff are very kind. Some residents described the home as being a home from home. Mrs Arithoppah reported that all new staff have received the equivalent of the TOPPS induction and foundation programme and staff continue to be supported to undertake a variety of training to equip them to perform their duties. Training includes mandatory courses, such as first aid, manual handling, food hygiene, and health and safety, Dementia and NVQ training. Mrs Arithoppah places the emphasis on staff undertaking external and recognised courses. Other training planned relates to medication and infection control. Sheldon Lodge DS0000028697.V283661.R01.S.doc Version 5.1 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 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): 35 Residents’ financial interests are safeguarded by either themselves or their families. EVIDENCE: Standard 33 was not fully assessed during this inspection. However, discussion took place about the benefits of developing a report, which could be made available to all current and prospective residents and their families, which outlines the positive and any negative comments received from the surveys undertaken by the home about the care and services provided. This report could be attached to the home’s service users’ guide and updated yearly. A copy of this report must also be forwarded to the Commission for Social Care Inspection. Mrs Arithoppah reported that the home does not have any involvement with residents’ finances. Residents are encouraged to manage their own financial affairs with the assistance of their family members or representatives. As a
Sheldon Lodge DS0000028697.V283661.R01.S.doc Version 5.1 Page 18 result the home does not undertake the role of appointee or hold any money for the residents’ safekeeping. Any expenditure such as hairdressing is raised as an invoice by the home and given directly to the residents’ representative. Sheldon Lodge DS0000028697.V283661.R01.S.doc Version 5.1 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 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 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 3 3 X X 3 X X STAFFING Standard No Score 27 3 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X N/A X X X Sheldon Lodge DS0000028697.V283661.R01.S.doc Version 5.1 Page 20 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. Standard Regulation Requirement Timescale for action 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 Sheldon Lodge DS0000028697.V283661.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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