Inspection on 13/01/09 for Sheldon Ridge Nursing Home

This inspection was carried out on 13th January 2009.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Sheldon Ridge Nursing Home 26/05/09

Sheldon Ridge Nursing Home 16/01/08

Sheldon Ridge Nursing Home 09/03/07

Sheldon Ridge Nursing Home 27/06/06

Sheldon Ridge Nursing Home 28/02/06

Sheldon Ridge Nursing Home 09/08/05

Sheldon Ridge Nursing Home 09/02/05

Sheldon Ridge Nursing Home 11/08/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

Pennine Camphill

Muston Road (70)

Grayling

The Cornerstone

John Street Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Sheldon Ridge Nursing Home 1/3 Bierley Lane Bradford West Yorkshire BD4 6AB     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Caroline Long     Date: 1 3 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: Sheldon Ridge Nursing Home 1/3 Bierley Lane Bradford West Yorkshire BD4 6AB 01274688029 01274684320 sueroberts@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Brunel & Family Housing Association Limited Type of registration: Number of places registered: care home 13 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Sheldon Ridge is registered to provide long term nursing care for thirteen adults with challenging behaviour, physical needs, and learning disabilities. The home is situated in the village of Bierley and is close to local amenities and a main bus route into Bradford City centre. The home was originally two purpose built bungalows; an extension now links the bungalows. There are communal lounges and dining areas and all bedrooms are single occupancy. The home has an enclosed rear garden, with level access from the lounges. The provider of the home is Yorkshire Housing Trust, many of the staff are employed by Bradford District Care Trust. 13 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: Information provided by the manager on the 20th January 2009 indicated that the current weekly fee for the home is from 479 to 971 pounds per week. Additional costs include the provision of extra support by staff, toiletries, hairdressing, holidays, leisure activities and clothes. This is what we used to write this report. We looked at information we have received about the home since the last key inspection. We asked for information to be sent to us before the inspection, this is called an annual Care Homes for Adults (18-65 years) Page 5 of 31 quality assessment questionnaire. We sent surveys to the staff and health professionals, we received three surveys from staff and one from a GP. We also talked to two relatives. One inspector visited the home unannounced. This visit lasted over seven hours and included talking to the staff and the manager about their work and the training they have completed, and checking some of the records, policies and procedures the home has to keep. We spent time observing how staff interact with people in the home. We looked at three peoples care records to check that a plan had been formulated which helped staff provide support to people according to their needs and wishes. We focused on the key standards and what the outcomes are for people living in the home, as well as matters, which were raised at the last inspection. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the care home does well: What has improved since the last inspection? What they could do better: To provide people with a fuller and more active lifestyle of their choice. A review of everyones daily life and activities must be carried out to make sure any activities are tailored to reflect peoples individual needs. To provide people with a comfortable place to meet the communal areas must be Care Homes for Adults (18-65 years) Page 7 of 31 refurbished. To make sure peoples health and welfare needs are always met more staff must be employed in the home. To keep everyone safe where a health and safety issue is identified this must be resolved in a manner which considers everyones best interest and keeps everyone safe. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 31 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People will be assessed before admission to the home to make sure Sheldon Ridge is the right place for them. Evidence: The home has been fully occupied since 2005, therefore we could not talk to anyone who had recently moved into the home about their experience or look at their records. However the manager told us that people are normally referred to Sheldon Ridge from Bradford District Care Trust. She will normally visit them and carry out a full assessment of their health and personal care needs and gather other information from relatives and any other agencies involved. Following this if she believes the person has the potential to settle in and staff have the necessary skills and the home has the proper equipment to meet the persons needs, they will be invited to visit. The visits are taken at the persons pace and can be for a day or overnight and last up to three months. This provides them with the opportunity to meet everyone and to get Care Homes for Adults (18-65 years) Page 10 of 31 Evidence: a feel for the home and helps the staff to be confident they will settle in. The manager explained how for some people whose physical needs had changed the staff had recognised they were no longer able to meet peoples needs and how she was requesting their placements be reviewed to make sure they were living in the most suitable environment. At our previous inspection to make sure that everyone has the right information about the home, we asked for the service user guide to be updated to reflect changes in the home. The manager told us in the annual assessment questionnaire this had been reviewed and is now available to people living in the home and their relatives. Also she is working towards this being available for people in pictorial format. We also asked that people were supported to understand this and their contracts. We found some people now have access to a advocacy service and for others the manager explained she was working with them using pictures to explain their rights in the home. We were able to see the complaints policy, which is now described in pictures. Care Homes for Adults (18-65 years) Page 11 of 31 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although the staff understand the right of individuals to take control of their lives and to make their own decisions this is compromised by inadequate numbers of staff. Evidence: People living at Sheldon Ridge have very complex needs, which can mean they have difficulty in communicating their views verbally. However we were able to see and staff told us about how they are able to recognise a persons preferred choice by how they are behaving. We found the care plans had very good information about how a person communicated through their behaviour and how to interpret this behaviour. At previous inspection we asked for the support plans to be fully completed. We looked at three peoples case records in order to check that a plan had been formulated which would help staff provide support to people according to their needs and wishes. We found the information in the support plans was up to date and in some areas quite Care Homes for Adults (18-65 years) Page 12 of 31 Evidence: detailed especially around peoples behaviours, where there was very good descriptions of how people communicate and how to protect them and keep them safe. However there were other parts where general descriptions were used such as staff need to assist me to the bathroom where I like to have a bath. Staff need to be with me at all times as I sometimes become agitated and vocal. I am unable to bath myself. Although this tells us what needs doing it does not tell us how the person likes it to be done, such as do they need help to get in, do they use soap, do they need help or prompting to wash themselves. Also another support plan did not have information about a persons specific behaviour. We found people had in place an assessment of the persons mental capacity which evidenced whether or not they had the capacity to agree with parts of the support plan. Many people living in the home have very complex needs and so are often at risk of hurting themselves. Assessments of these risks must be made to protect people from potential harm and to provide staff with the actions they need to take to minimise any risks to individuals. At Sheldon Ridge we found part of the support plans had details of any possible risks to the person, and where a person may encounter specific risks, such as when they travelled in the mini bus or when they went swimming, a risk assessment was in place. The manager and staff also told us about the risks to people and the actions they would take to minimise these risks. The nursing staff told us due to inadequate numbers of staff they found it difficult to keep the records up to date. However when we talked to staff they were able to tell us about peoples specific needs and we observed three staff providing support to a person in a way, which the support plan said they liked. The staff told us they had a handover meeting that informed them about any changes when they started work. Overall although the support plans contained some good information, others lacked necessary details and their size made them difficult to navigate and to find relevant parts. We discussed with the manager how the plans could be improved upon by taking out any old or unnecessary information. Staff told us people are encouraged to make as many decisions and choices as possible within the limitations of their disability. Also when they could not make their preferences known verbally how they were able to understand their facial expressions or behaviour and were aware of their likes and dislikes, this information was also in peoples support plans. However staff told us how they did not always have enough time to offer people choices and how this also limited peoples choices. Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: The staff also explained how the manager was working at enabling people to make more choices, by the use of photographs and pictures more in the home. Care Homes for Adults (18-65 years) Page 14 of 31 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The opportunity to take part in a choice of daily activities is compromised by lack staff and a poor communal environment. Evidence: The home now employs two full time and one part time activities co-ordinators, who told us people now have some access to activities both inside and outside the home. The manager has also put into place activity plans for people and a system to be able to see how often they have the opportunity to access or be helped to participate in activities. When we visited a person went out bowling and for lunch and during the afternoon people were having their nails polished. We were also told about people going swimming and one of the activities co-ordinators told us due to the managers Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: reorganisation she has more time to spend engaging people with their activities. An example she gave was the GP now visits the home weekly to see people, before this, she would have to accompany people to the doctors regularly. Two relatives also confirmed their relatives went out occasionally. However we were told by staff that because people have very complex needs and the activities have to be carried out in the home on a one to one basis or when people are helped to access the community on a two to one basis, the opportunity for them to access activities is very limited. We were able to see this during our visit where although one person was taken out, others remained in the lounges with little to stimulate them. We saw one person walking around the home for most of the day, however their support plan told us they liked to go out for walks. Also both the lounges were institutional, resembled waiting rooms and contained sofas only. The televisions were small and located high on shelves in the corner of the rooms. This would have made them very difficult for people to see. We asked the staff if people would want to see the televisions and they explained some may find enjoyment by hearing them or seeing the colours. The provider must look at ways of providing people with a communal area which enables people to engage in appropriate activities for their needs. The manager in the annual quality assessment questionnaire told us how they are hoping to employ a driver/support worker to enable people to access the community more. There were no visitors in the home when we visited however the manager and staff explained most peoples relatives visit at the weekend. Two relatives told us how welcoming staff were when they visited. We saw the dining rooms were very clean but would have benefited from a more homely approach. The cook explained people have lunch at twelve and tea at four in the afternoon. He explained most people will indicate their choice through refusing to eat the food offered. The manager told us how they are taking photographs of the different foods so a pictorial menu can be made so people can be encouraged to make choices. Staff and relative told us the food was very good. Care Homes for Adults (18-65 years) Page 16 of 31 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident the health and personal care they receive is based on their individual needs, however insufficient staff could compromise this. The principles of respect, dignity and privacy are followed by staff. Evidence: One relative described the care people receive as very good, no complaints A general practictioner commented As a GP I feel the staff are totally committed to peoples health needs, and I have never failed to be impressed by the staff and their respect. A advocate described how the staff had been really good when promoting a persons health care needs and how they had looked at many ways of improving their quality of life. People were observed to be clean, in matching clothes and a relative told us this was normally the case when they visited. Support staff were also seen to treat people with Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: warmth, respect and kindness. However all the staff told us due to peoples complex needs and level of dependency they have only enough time to provide people with their basic needs and to keep them safe. Although staff told us they did not always have time to write the records when we looked at the support plans people health and care needs were described and we found staff were aware of peoples health care needs and were prompting peoples access to the health care they need. The manager and staff explained how the GP now visits the home weekly to monitor peoples healthcare and how this had improved the relationship with the GP and people preferred to be seen in a familiar environment. Staff told us people do have named nurses and key workers. Medication is locked away and a monitored dosage system is used. Staff who give out medication have received training. A sample of medication administration sheets were checked and found to be correct. However a nurse did describe how they have difficulty in completing the administration of medication without being disturbed due to the lack of staff. Care Homes for Adults (18-65 years) Page 18 of 31 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with the support and information they need to raise concerns about the service. Evidence: The manager explained all complaints about the service go to Yorkshire Housing, if there are complaints about staff the provider Yorkshire Housing shares this with the staffs employer Bradford District Care Trust. The manager also told us to help people understand how to complain, the complaints policy is now available from Yorkshire Housing in picture format and in a DVD. Staff explained how they would be able to see if a person was unhappy by their body language. Two relatives told us they were aware of who to complain to and would feel comfortable to make their views known. We have not received any complaints about the home. The manager told us there have been three complaints following the last inspection, which have been fully investigated. We looked at the complaints and found they had been addressed and responded to. The manager told us how copies of complaints are kept on people files and to enable her to improve the home she keeps a record of complaints so she can identify any patterns. We found staff are completing incident forms, this is required so the staff can identify any patterns. These are sent to Yorkshire Housing who collate them to identify any Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: possible patterns or possibilities of reoccurrence. The manager told us she monitors these to identify any patterns and she would use this information at peoples reviews. We looked at the incident forms and found although there were indications the staff were using some types of low level restraint to protect people from harm, the type and methods were not being recorded. The manager agreed to ensure staff commenced recording this immediately. People are provided with an independent advocate if needed. A copy of the local policy and procedure, No Secrets, is available for reference. Discussion with the manager showed she was aware of the actions to take to safeguard adults. Staff said they have received training in adult protection and safeguarding issues either during induction or as part of their national vocational qualifications. Three staff were aware of whom to alert if an incident occurred. People are supported with their finances. Detailed records are kept of all financial transactions carried out by the individual or by staff on their behalf. Care Homes for Adults (18-65 years) Page 20 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Improvements need to be made to the home to make it a comfortable and clean place to live. Evidence: Sheldon Ridge is two adjoining bungalows that together jointly accommodate thirteen people. There are communal lounges and dining areas, and toilet and bath facilities and all the bedrooms are single. We looked at two peoples bedrooms which were clean, and comfortable, and furnished to peoples personal interests and tastes. They contained special lights and sensory equipment for people to use. However the communal areas, such as the lounges only contained sofas were very institutional and looked like waiting rooms. They also did not have anything to make the rooms feel homely or to provide people with any type of comfort or stimulation. The walls were grubby and many of the areas had scratched or marked paint. There is a small sensory room and we were told at the last inspection this was to be refurbished and no longer used for storage. We found this continues to be used for Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: storage and has not been refurbished. At the previous inspection we asked for the home to provide us with a plan of refurbishments for the home particularly for the shower room and for the heating to be improved and a nurse call alarm installed. We did find the shower room had been refurbished and the manager told us there is a programme of refurbishment planned for the home. We also found the nurse call system had been installed and the heating had been improved. However due to the poor standard of the communal areas we must ask for a plan to show us how and when these will be improved in 2009. The manager and staff explained how as peoples physical needs had increased the home did not have the necessary equipment or space to enable them to care for people safely. For instance the width of the corridors is restrictive and some of the rooms are too small. We were also able to see the difficulties staff were encountering. To promote safe practices in the home when peoples physical needs increase the manager must make sure their needs are assessed to make sure the environment remains suitable. Although the manager explained the paint is not the type which the staff can wash some area were not clean enough and,the communal areas appeared grubby and had unpleasant odours. To help prevent the spread of infection staff have had infection control training and gloves and hand wash are available throughout the home. Care Homes for Adults (18-65 years) Page 22 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Inadequate numbers of staff means peoples needs are not always met. Evidence: A GP commented Everything I have seen has been done well, but also commented they have a number of high need patients but are not staffed to provide 24 hours one on one care. A relative told us staff attitude is good, all are approachable and loving and more than willing to help. We found there are normally six staff working during the day and evening. These are five support workers and one nurse. They are also supported at times by two full time and two part time activities co-ordinators. There are thirteen people living at Sheldon Ridge but all have very complex physical and mental health needs. Three people require one member of staff to supervise them constantly during the day and evening. When people become distressed up to four staff could be needed to promote safe practices and keep them safe. The nurse is responsible for the administering the medication and liaising with health professionals. When people are helped to access the community for various appointments or activities they often need two staff to Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: escort them. Staff told us and we observed that although there are enough staff available to meet peoples basic care needs and keep people safe, staff are not able to meet peoples lifestyle needs or make sure people have the opportunity to make choices. Two staff commented that because of some people needing one to one support other people needs are not met. So the manager can be confident proper recruitment practices are followed and only suitable people are employed at the home, at the previous inspection we asked that all staff recruitment and supervision records must be held in the home. We found for anyone who had started work since the manager had been appointed the correct records were in place. Also for those who had previously been employed by the Trust she was in the process of gathering the information together and she had been successful in making sure all staff have a criminal record bureau check in place. The manager explained that some of the staffs training needs to be updated we were also able to see that staff have not been provided with training about the mental capacity act or how to carry out different physical interventions safely. Both of these specialist training course will help staff to protect the people who they provide a service for. As the staff and the incident forms show that staff do occasionally have to use physical interventions in order to protect themselves and others it is crucial the home train the staff to do this properly. Also new staff, who have no previous experience, need to be provided with this training prior to them working with anyone who may have challenging behaviour, this is to keep everyone safe. This shows us the staff must be provided with further training. Staff told us they received regular supervision and appraisals from their manager and do feel supported by the management. Staff confirmed they have regular meetings and the manager explained these are used as a opportunity to recap policies and to make sure staff are kept up to date and able to carry out their roles properly. The annual quality assessment questionnaire states over half of staff have their National Vocational Qualification level two or above in care, this qualification helps to make sure staff are properly trained to carry out the work. Care Homes for Adults (18-65 years) Page 24 of 31 Care Homes for Adults (18-65 years) Page 25 of 31 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although the manager and the staff are trying to improve the service, and promote peoples best interest this is compromised by lack of support from the provider. Evidence: The new manager started working at Sheldon Ridge in May 2008, she has vast experience of working with people with learning disabilities and is a registered nurse. We found she is committed to improving the service and is trying to promote the best interest of people who live in the home. We were able to see some of the systems and changes she has already made to improve the service for people at Sheldon Ridge and staff told us about the improvements she had made and how they felt very supported by the manager. One staff commented in their survey I feel that on the whole Sheldon Ridge has improved as a service having a regular manager. The manager discussed with us the importance of person centred care and effective outcomes for people who use the service, she told us how she works towards making sure the home is run in the best interests of the people who live there. However it is Care Homes for Adults (18-65 years) Page 26 of 31 Evidence: shown in this report that more support must be provided by the provider to enable her to manage the service in peoples best interests. The manager has completed an annual quality assurance assessment which contains, clear, relevant information this supported by a wide range of evidence. The AQAA lets us know about changes they have made and where they still need to make improvements. It shows clearly how they are going to do this. The data section of the AQAA fully completed. Quality assurance systems consisted of regular visit from the district manager and an annual survey for people with a interest in the survey to complete, care reviews, and relative meetings etc. The manager was able to show us some of the quality surveys she had recently received from relatives and health professionals, all had responded positively about the home. The annual quality assessment questionnaire states the maintenance and service records are in order and the manager has completed an intermediate health and safety certificate to enable her to ensure the health and safety of service users and staff. However we found there had been a health and safety issue identified in October 2008 which was putting both an individual and the staff at risk, this must be resolved in a manner which considers everyones best interest and keeps everyone safe. Care Homes for Adults (18-65 years) Page 27 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 28 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 12 16 People must be offered regular activities which are tailored to reflect their individual needs. This will provide people with a better more fulfilling lifestyle. 01/04/2009 2 28 23 You must provide us with a 31/03/2009 schedule which tells us when and how you will be improving the communal lounge areas. This is to help make Sheldon Ridge a more comfortable place for people to live. 3 33 18 You must have enough staff 02/03/2009 working in the home to meet peoples health and welfare needs. This is to make sure everyones needs are met. 4 42 13 The health and safety issue identified at the inspection must be promptly resolved in everyones best interests. 02/03/2009 Care Homes for Adults (18-65 years) Page 29 of 31 This is to prevent accidents and keep people safe. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 6 Care plans need to be up to date and person centred and include more information about how people communicate their preferences and needs. Risk assessments should be updated regularly and identify any possible risk to the person and provide staff with the actions they needed to take to minimise any risk whilst promoting peoples independence. The registered provider should make sure the staff are trained to follow the recommended guidance from the Department of Health, for Restrictive Physical Interventions and How To Provide Safe Services For People With Learning Disabilities And Autistic Spectrum Disorder. This guidance helps the support workers to know how to make sure people who use the service are kept safe. 2 9 3 32 Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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