Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 26/05/09 for Sheldon Ridge Nursing Home

Also see our care home review for Sheldon Ridge Nursing Home for more information

This inspection was carried out on 26th May 2009.

CQC 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.

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

One relative told us they were very confident the recent changes in management would lead to improvement for people at Sheldon Ridge. They also said Sheldon Ridge generally has very good staff which needed support direction and leadership.

What the care home could do better:

At the last inspection we made four requirements and four recommendations, although there have been some improvements, we found evidence to show us that some of the requirements and recommendations are still not fulfilled. There must always be enough staff available to ensure people`s needs are fully met. To provide people with a comfortable place to live the communal areas must be refurbished and the Commission provided with a plan of when this is going to happen. To provide everyone with a fuller and more active lifestyle of their choice. Staff must review people`s chosen activities to enable staff to support people to carry them out. People need to be referred to specialist health care services and staff must be adequately trained to recognise and meet the needs of anyone who has a specailist health care need.

Random inspection report Care homes for adults (18-65 years) Name: Address: Sheldon Ridge Nursing Home 1/3 Bierley Lane Bradford West Yorkshire BD4 6AB one star adequate service 13/01/2009 The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Caroline Long Date: 2 6 0 5 2 0 0 9 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): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Brunel & Family Housing Association Limited care home 13 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: Date of last inspection Brief description of the care home 13 1 3 0 1 2 0 0 9 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. Care Homes for Adults (18-65 years) Page 2 of 12 Care Homes for Adults (18-65 years) Page 3 of 12 What we found: At the key inspection carried out on the 13th January 2009 Sheldon Ridge was awarded a one star adequate quality rating and four requirements and some recommendations were made. Following this inspection there has been a change in management at Sheldon Ridge and we have received complaints about the changes and a health and safety issue. We carried out this random visit to look at whether the change of management had affected the service and what actions had taken place to improve the service. Two inspectors visited Sheldon Ridge on 26th May for four hours in the evening. When we visited Sheldon Ridge it was apparent the home has other areas where improvements are necessary these have not been looked at during this visit. However we will be returning to Sheldon Ridge to carry out another inspection before the end of 2009. We saw the home has twelve people with very complex and different needs, who live in two adjoining bungalows. Two relatives and the staff made very positive comments about the changes in management. They said there have been several changes of management and the new manager had experience and a very positive approach. They said they felt confident the new head of service will address issues which have not been addressed, will deal with the institutionalisation, and that they want the people to have as normal a life as possible. We looked at two peoples support plans to check that a plan had been formulated which would help staff provide support to people according to their needs and wishes. We found one was a detailed plan of care with risks identified and planned for as part of the care planning process. The plans were easy to follow and person centered, they described how the person likes things to be done, for example their personal care. The plans had been regularly evaluated to make sure they were still current. However the second support plan had gaps in how to provide a person with the support they needed to help them communicate. Where it identified intensive interaction as a way of helping the person to communicate, there was no information to explain what this meant or how to carry it out. Talking to the staff who were supporting this person also identified they were unaware of how to carry this out. We found where the support plan told us this person had nutritional needs the staff were not able to tell us how they were monitoring the amount of food and drinks the person had each day. Also the plans had been developed and written by a named member of staff and there was no evidence people, their relatives or an advocate had been involved. This tells us there are still gaps in some peoples support plans which need to be addressed by the new managers working at the home. Staff asked people what they wanted to do, for example, play ball, listen to music, read magazines, go outside. They respected peoples choices, especially if they refused the activity offered. Staff did not force people to be involved if they didnt want to. They respected peoples need for personal space. Care Homes for Adults (18-65 years) Page 4 of 12 Although people are able to make some choices these are very basic and sometimes restricted. An example is the staff told us they have to help people into their night wear from 7 pm this is because there are not enough staff working on a night shift to help people later. At the previous key inspection we asked for people to be offered regular activities which are tailored to reflect their individual needs. We found in one of the bungalows there was a calm atmosphere, some activities were introduced at a pace that suited the people there and there was good interaction from staff, they were warm, friendly and thoughtful. Some people were playing an interactive ball game with staff, others were listening to music or sat with staff while staff stroked their head or just held their hand. In the other bungalow people were sat in arm chairs or wandered aimlessly around and staff generally did not interact with them but just observed them. There were no organised activities in this bungalow. There was an activity organiser on duty who shared her time between people. Some of the time she was doing craft type activities and an outing to a local pub disco was arranged for three people. However in both bungalows some people looked bored at times and fell asleep in the chair or on the settee. One person who had a visual impairment displayed a type of behaviour which could have been a sign of boredom. When we asked staff if they had any specialist input regarding their visual impairment, staff did not know if this had ever been done or considered. When we looked at one persons records of activities we found they were allocated Monday afternoons to go out, however there had been a number of bank holidays so the records showed they had only been out twice in April. There was also little evidence of how people are involved in the running of the home. Staff had to leave the main lounge areas if anyone needed any support with personal care or behavioural issues. This left the people in the lounge unsupervised and without staff for the activity they were undertaking for short periods of time. Staff said they felt they did not have enough staff to provide a decent level of activity and meet peoples personal care needs properly. Staff also said that they did not have enough staff at mealtimes. One said, its a very busy time, too many people to feed and not enough of us. People looked clean, well groomed and cared for. There was attention to detail such as people having their nails painted. Specialist clothing had been obtained from specialist suppliers to ensure peoples dignity and comfort were addressed. Also we saw staff were discreet when offering personal care. Staff gave good responses when asked how they ensure peoples privacy and dignity. They were able to describe what they do. Comments included: We always shut doors for any personal care Make sure what we do for people is done in private.. Staff were able to describe peoples support needs and routines well. It was clear they have good knowledge of peoples needs and health problems. They were able to describe how people are affected by their health needs, for example epilepsy and constipation. They were also able to describe how people expressed they were in pain. Also support Care Homes for Adults (18-65 years) Page 5 of 12 plans relating to personal care and grooming were detailed and gave staff specific instruction on how to care for the person. Relatives told us the health care people receive is excellent and one of the records also showed that a persons health care needs had been assessed and planned for. However on one occasion, someone tried to remove their clothing to indicate they wanted the toilet. Staff did not adjust their clothing but walked them through to the toilet with their pants half way down. This did not maintain their dignity. One person who lives at the home was displaying some behaviours that compromised his dignity at times. Staff did not intervene or try to re-diect them to a more appropriate activity. Also we saw staff were discreet when offering personal care. Staff did however say that they had not received training in meeting peoples specialist health needs. One staff member said they had not received training in epilepsy management but that if someone had a fit they would, Put them in the recovery position, check they had nothing in their mouth and call for help. When looking at the persons care plan for epilepsy it did not say to put them in the recovery position but to make them comfortable and loosen any tight clothing. This lack of knowledge from staff could lead to injuries to staff and people who use the service. Staff had not been trained in meeting peoples nutritional needs. It was clear that a number of people at the home are slight and under weight. Records showed that weights were monitored, however, food intake wasnt. This could lead to their needs being missed or overlooked. Also a referral was made November 2008 for podiatry, dental and audiology treatment and this had not yet come through. The staff nurse said waiting lists could be up to a year. We would recommend that follow up by staff is needed to check on these referrals, make sure they havent been forgotten and that staff record they have done this. Staff were able to give examples of how people displayed they were unhappy. They said they then go through a process of elimination, bearing in mind, peoples limited verbal communication, to try and find out what may be making someone unhappy. Staff told us they had undertaken training on safeguarding vulnerable adults as part of their NVQ or LDAF (Learning disability award framework) training. They were able to describe different types of abuse and describe what they would do if they witnessed or had an allegation of abuse made to them. They said they would report it to the senior nurse on duty or to a manager within the Trust, however they were unaware of the Local Authority Adult Protection Unit. When any incidents had occurred the staff had completed an incident form, this enables them to identify if there are any patterns to peoples behaviours. However these often did not contain enough detail about how the injuries had occurred. When we talked to the staff they were able to tell us how people had injured themselves but this was not always recorded on the incident forms. To protect everyone the staff need to make sure they explain how injuries have occurred on the incident forms. People at Sheldon Ridge have very complex needs and behaviours which can result in people becoming very agitated, to help the staff to care for them safely they need to be provided with specialist training on how to calm a person and if necessary how to use Care Homes for Adults (18-65 years) Page 6 of 12 physical interventions safely. When we talked to staff we had a very mixed response of whether they had this training. The management need to be confident all staff have completed this training before they start work at Sheldon Ridge. At the previous inspection we asked to be provided with a schedule about when and how the communal areas would be improved. We have not received the schedule and during our visit we found the communal areas remain very sparse and institutional and one of the bathrooms was out of use. However there were signs that areas of the home were about to be re-decorated. Staff told us they felt they pulled together well and supported each other. They said they had supervision on a regular basis and the new manager was also working alongside them to see how they do their job. They told us they did feel supported by the new manager. A relative told us the home has very good staff. At the previous inspection we asked the home to have enough people working in it to ensure peoples health and welfare needs were met. We found staff told us there are five or six staff working during a day from 7am to 9pm and one member of staff stays until 10pm. These are supported by the two full time and one half time activities co ordinators, domestic staff and a cook. Staff said they felt well supported by the manager and nursing team. Staff did however say that they didnt feel they had enough staff, especially when two of the staff on duty are providing one to one support for two people who live at the home. They also said that some people who live in the home need two to one support to go out in the community and others need two to one support for their moving and handling needs or personal care. We also found on a late evening and a night the numbers are significantly reduced to one nurse and two support workers, although one person still needs one to one support. This indicates to us that there are not enough staff working at Sheldon Ridge to keep everyone safe and to fully meet their needs. The staff nurse in charge said the new manager was looking at the staffing issue and hoping to develop new rotas which would mean there was a qualified nurse on duty in each bungalow. At the previous inspection we asked that a health and safety issue we identified at the inspection must be promptly resolved in everyones best interests. And although not fully in place, we found the persons relatives have been consulted and improvements are being made which will result in a safer environment for the person and the staff at Sheldon Ridge. What the care home does well: What they could do better: Care Homes for Adults (18-65 years) Page 7 of 12 At the last inspection we made four requirements and four recommendations, although there have been some improvements, we found evidence to show us that some of the requirements and recommendations are still not fulfilled. There must always be enough staff available to ensure peoples needs are fully met. To provide people with a comfortable place to live the communal areas must be refurbished and the Commission provided with a plan of when this is going to happen. To provide everyone with a fuller and more active lifestyle of their choice. Staff must review peoples chosen activities to enable staff to support people to carry them out. People need to be referred to specialist health care services and staff must be adequately trained to recognise and meet the needs of anyone who has a specailist health care need. 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 2. Care Homes for Adults (18-65 years) Page 8 of 12 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 9 of 12 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, 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 Staff must review peoples chosen activities to enable staff to support people to carry them out. This will provide people with a better more fulfilling lifestyle. Previous timescale not met of 01/04/09. 30/06/2009 2 28 23 You must provide us with a 30/06/2009 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 to live. Previous timescale not met of Previous timescale not met of 31/03/09. 3 32 18 Staff must be trained in 30/06/2009 meeting the specialist health needs of people who live at the home. This will help to make sure people health care needs are Page 10 of 12 Care Homes for Adults (18-65 years) Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 met. Previous timescale not met of 31/03/09. 4 32 18 You must have enough staff 30/06/2009 working in the home to meet peoples health and welfare needs. This is to make sure everyones needs are met. 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. People should be referred promptly for any specailist health care support they need and these referrals should be regularly followed up to make sure they are not forgotton. Staff need to be aware of who are the appropriate organisations they need to report any safeguarding issues to outside of the organisation. When completing incident report forms staff need to provide more detail, so the person reviewing the forms can identify the possible cause of any injuries. 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. You should continue to promptly resolve the health and safety issue identified at the last inspection. Page 11 of 12 2 19 3 23 4 23 5 32 6 42 Care Homes for Adults (18-65 years) Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 12 of 12 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!