Inspection on 27/12/08 for Shelley Park & Shelley House

This inspection was carried out on 27th December 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Shelley Park & Shelley House 19/09/06

Shelley Park & Shelley House 16/01/06

Shelley Park & Shelley House 28/06/05

Shelley Park & Shelley House 13/01/05

Shelley Park & Shelley House 07/07/04

Shelley Park & Shelley House 29/03/04

Similar services:

The Vicarage

7 Hyde Road

5 Seafield Road

Trevaylor Manor

12 Orchard Mews

Stallcombe House

Stepping Stones

Cornerstones

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

CARE HOME ADULTS 18-65 Shelley Park & Shelley House 32 Florence Road Boscombe Bournemouth Dorset BH5 1HQ Lead Inspector Melanie Edwards Key Unannounced Inspection 27th December 2008 09:00 Shelley Park & Shelley House DS0000020492.V368560.R01.S.doc Version 5.2 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 Shelley Park & Shelley House DS0000020492.V368560.R01.S.doc Version 5.2 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. Shelley Park & Shelley House DS0000020492.V368560.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Shelley Park & Shelley House Address 32 Florence Road Boscombe Bournemouth Dorset BH5 1HQ 01202 396933 01202 396933 shelleypark@lineone.net. 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) Shelley Park Limited Miss Simone Clare Garland Care Home 37 Category(ies) of Physical disability (37) registration, with number of places Shelley Park & Shelley House DS0000020492.V368560.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home with Nursing - Code N to service users of either gender whose primary care needs on admission to the home are within the following category: 2. Physical disability (Code PD) The maximum number of service users who can be accommodated is 37. 19th September 2006 Date of last inspection Brief Description of the Service: The home provides care for up to thirty-seven younger adults who have some form of neurological dysfunction. It is situated in a residential area of Boscombe close to the shopping centre and within easy walking and wheelchair distance of the promenade and beaches. There are good transport links both locally and nationally, with several bus stops and coach and train stations situated nearby. The current fee range is between around £600 to around £1500. Shelley Park and Shelley House are two buildings located in the same grounds and owned by Shelley Park Ltd. A pleasant garden with garden furniture separates the two buildings. There is off street parking at the front of the building for visitors or parking is available on the main road and side streets, directly outside the home. Shelley Park is the main residential unit and Shelley House ground floor is used for daily living activities, therapy sessions and rehabilitation. There is a small snoezelen (multi-sensory) room and adapted kitchen area. This building also provides office accommodation on the first floor for the owners and the administrator. Shelley Park provides accommodation over four floors and a lift is available to floors 1 - 3. The home has 21 single bedrooms 1 of which has an en-suite facility and 5 double bedrooms. Shelley Park provides care for young adults both male and female with neuro disability resulting from a wide range of conditions including severe brain injury or disease, multiple sclerosis, cerebral palsy, stroke and spinal injury. Shelley Park & Shelley House DS0000020492.V368560.R01.S.doc Version 5.2 Page 5 The home has its own transport and regularly organises social outings. Shelley Park & Shelley House DS0000020492.V368560.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. We carried out the inspection over one day and we spent nine hours in the home. Please note some of the residents cannot directly express their views as they have profound and multiple disabilities. This has reflected the way that the report has been written. We met eight of the residents who are living at the home. We also spoke to a number of visitors. We met the senior on call manager who came to the home for part of the inspection. We spoke to the registered manager by telephone. We met two registered nurses; four care assistants and the chef. We spent time observing residents and staff together. We looked at a number of different records relating to the day-to-day running and management of the home. The records we saw included three care plans, three assessment records, medication records, staff duty records, supervision records, accident records, fire records, finance records and menus. We saw the majority of the environment. The only areas that we did not see were a small number of bedrooms. What the service does well: Residents’ needs are assessed in really good detail before they move to the home. This helps ensure residents needs can be met by the home. Residents benefit from really helpful and informative care plans in place. The care plans show very well how residents will receive help with personal care in the way that they prefer. We saw throughout the inspection that residents receive sensitive care that aims to meet their physical and emotional needs. Residents’ rights are respected and there are good systems in place to make sure residents can have responsibility in their daily lives as much as they can. Residents and their representatives are provided with assistance to make decisions about their lives. Shelley Park & Shelley House DS0000020492.V368560.R01.S.doc Version 5.2 Page 7 Residents are very well supported to take part in a really varied range of activities. This means residents can take part in their preferred interests. Residents enjoy good links with the local community. Family members and significant others are welcomed by the staff. This helps residents to maintain relationships that matter to them while they are in the home. Residents and their representatives have access to an easy to follow complaints’ procedures. This helps residents to feel confident that staff members will listen to any concerns they may have and deal with them properly. Residents are ‘safeguarded’ from abuse by the homes policies and procedures, staff training and detailed written risk assessment records showing how to keep each resident safe. Residents live in a safe satisfactorily maintained environment. The home provides residents with a comfortable place to live. Residents are cared for by staff that are well trained. This helps residents’ needs to be well met. Residents befit from a home that overall is really well run. The health and safety of residents is protected. What has improved since the last inspection? Residents’ benefit from having individual written nutritional risk assessments in place. These help ensure residents’ often very complex dietary and nutritional needs can be met. Residents care plans are really clear and reflect really well how to provide the care and how to meet residents’ needs. Residents’ medication administration records contain the necessary information if residents have sensitivity to medication to ensure residents stay safe. Residents risk assessments are very up to date and reflect really well the homes own policies and procedures. The home has ensured recruitment practices are in order thereby keeping residents’ safe. The home is clean and tidy. Shelley Park & Shelley House DS0000020492.V368560.R01.S.doc Version 5.2 Page 8 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. The summary of this inspection report can be made available in other formats on request. Shelley Park & Shelley House DS0000020492.V368560.R01.S.doc Version 5.2 Page 9 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 Shelley Park & Shelley House DS0000020492.V368560.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2.Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can get hold of the information that they need to help them make an informed choice about the home. Residents’ needs are really well assessed before they come to the home. This helps make sure residents needs will be met. EVIDENCE: To find out how prospective residents and their representatives are helped to find out about the home we read a copy of the residents guide and the statement of purpose. Residents’ representatives, or the residents themselves are given their own copy of the guide so they information about life in the home. There is information about the service provided, the qualifications of the staff employed, and the accommodation. The philosophy of the home and how the service aim to meet residents needs is included. The complaints procedure is in the document so residents know how to complain about the service. The service users guide is available for residents in a range of different formats including a tape version. This is a really good way to make sure people can find out about the home. We looked at three residents pre-admission assessment records to see how well residents needs are assessed before they come to the home. We saw a Shelley Park & Shelley House DS0000020492.V368560.R01.S.doc Version 5.2 Page 11 really detailed and informative level of information about each person’s very complex needs. We saw supporting information from external healthcare professionals to guide the staff in the home to fully understand the residents’ health care needs. We saw a really detailed care plan for each resident based on the assessment information we read .We will refer to this in the next section of the report. Residents have very complex needs and we found that there was a really good level of information that showed needs have been really well assessed. We saw in the assessments records that relatives and significant others are encouraged to play a part in the initial assessment process and to come and see the home. We met relatives who told us they had done exactly that, before their relative had moved in. Relatives we met told us that they are happy with the service that their relatives receive at the home told us. One relative said they would be very ‘vocal’ if there were any concerns about the home and they had not found any. Shelley Park & Shelley House DS0000020492.V368560.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ care plans are really detailed and informative and help staff meet residents’ needs. Residents are really well supported to be able to make decisions about their lives as much as possible. Residents are protected by a really detailed assessment process that identifies risks and allows them to enjoy independence as much as they can. EVIDENCE: We read three residents care plans to find out how their needs are being met. We found the care plans were really detailed, clear and informative. The care plans had really good level of information in them about each resident’s preferences. We also saw detailed information about how to help residents to be able to make some decisions in their daily lives. We saw in each care plan up to date information that showed the Mental Capacity of residents had been assessed. This can be a legal requirement for some residents. It means that Shelley Park & Shelley House DS0000020492.V368560.R01.S.doc Version 5.2 Page 13 residents rights to make decisions for themselves must be considered and fully taken into account at all times. We saw that residents care plans had been signed to show they have been discussed with the resident concerned or if applicable someone who represents them. We observed staff helping and supporting residents in the way that had been written about in the care plans that we read. One of the residents we met told us they ‘yes’ they do make decisions about their day-to-day life. We were also told by one of the residents we met how they can now live a more independent life. They told us they like to go out on their own for walks into the community on a regular basis. We saw very detailed daily records showing how the staff monitor and keep a very close watch on residents’ day-to-day health and well-being. We saw there are monthly reviews of each resident .In these reviews anything important that has happened to the resident is reviewed and any impact these may have had on them. We read three residents risk assessments records .Due to the very complex need of the residents there are also risk assessments carried out for each resident of their individual nutritional needs and how these are best met .We also saw up to date risk assessments of each residents manual handling needs as well as the risks of them getting a pressure sore. We found that the information in the assessments we read linked very closely to the information in each residents care plans. The care plans clearly showed us how to minimise the risks that resident may face to their health and well-being. Shelley Park & Shelley House DS0000020492.V368560.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are extremely well supported to take part in activities that suit their needs. This helps ensure residents can take part in their preferred interests, and an individual lifestyle. Residents are very well supported to maintain relationships with relatives and significant others. Residents’ day-to-day quality of life is enhanced by being a part of the community in which the home is situated. Residents’ rights are respected and they are really well supported to take as much responsibility for their daily lives, as they are able. Residents can enjoy a healthy and varied choice of meals. However residents’ mealtime experiences could be improved if their views were sought about the overall standard of the food provided. Shelley Park & Shelley House DS0000020492.V368560.R01.S.doc Version 5.2 Page 15 EVIDENCE: We spent time in Shelley House and met residents who were taking part in a range of therapeutic activities. Some residents were sitting together enjoying a glass of wine and watching television. One resident told us how much they enjoy and value spending time in Shelley House doing day care activities. Residents are very well supported by the staff to visit places of interest in the community. For example residents go shopping, out for meals, to the cinema and swimming. Residents who wish to are very well supported to go to church. We saw a really detailed amount of information in residents assessment records and care plans about the varied range of activities that residents like to take part in. Due to residents’ really complex needs, much of the social and therapeutic activities take place in Shelley House. As is written about in the homes statement of purpose the aim of Shelley House is to provide rehabilitation and therapeutic support. Two residents we met told us about how rehabilitation assistants help them improve and keep muscle tone and undertake daily living activities. We met a number of residents relatives and significant others during our visit. We were told by all the people we met how very satisfied and pleased they are with the care, support and commitment to ensuring their relatives or friends live a very varied and fulfilling life. We observed the staff knocking on resident’s bedroom doors before entering them. This shows how staff try and respect residents’ rights to privacy. We saw as well in care plans helpful information about what are the preferred names that residents like to be known by. We saw really helpful information in residents care plans that explained in very good detail the day-to-day routines that the person likes to follow. Two relatives told us how the staff always follow the routines and preferences of their relatives at the home when they are helping and supporting them. We saw residents sitting in different parts of home. We saw residents in their rooms, communal areas and in the reception area. This helps show how residents’ individual choices are encouraged. To find out if residents are being offered a varied and well-balanced choice of food we discussed the food that is provided with the chef on duty. We also looked in detail at the residents’ menu. In our discussions with the chef they demonstrated a good knowledge of the very varied dietary needs of residents. The menu we saw looked varied and well balanced. However a significant number of the people that we met told us Shelley Park & Shelley House DS0000020492.V368560.R01.S.doc Version 5.2 Page 16 that the overall standards of the meals in the home are very variable. We were told that meals can be really tasty and home cooked, or they can seem less flavoursome and less tasty. We observed at lunchtime that alternative meal choices are available for residents. We saw information in residents care plans that showed that diets are also prepared for residents who have very specific cultural needs. The chefs are able to meet the specialist dietary needs of residents who need pureed diets. The home puts on special themed nights including Chinese meals and fish and chip nights. There is also a regular lunch club held in Shelley House, where there is a kitchen used to prepare meals. Shelley Park & Shelley House DS0000020492.V368560.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20.Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported with their care in the way that they prefer and require. There are really good care plans in place to guide the staff to be able to meet resident’s needs well. Residents’ medication is handled safely and residents are protected by the homes medication practises and procedures. EVIDENCE: We read in the assessment and care plans details of resident’s needs and wishes in respect of the help that they receive with personal care. We saw very detailed information in the care plans about what type of support each resident needs and what equipment must be used to help them meet a full range of needs .We saw staff supporting residents with their personal care needs in a sensitive, very warm and friendly way. We saw a really detailed level of information in the assessment records and care plans about each person care needs. We saw in each resident’s records up to date information about their health and any related medical conditions. Shelley Park & Shelley House DS0000020492.V368560.R01.S.doc Version 5.2 Page 18 We saw very detailed information in resident’s records from other professionals who provide regular support and care to the residents involved, including physiotherapists, dieticians and occupational therapists. We saw up to date records of the names and contact details of people involved in each residents care .The home is also well supported by local General Practitioners as well as specialist nurses. This helps ensure resident’s very complex health care needs are well met. We saw very detailed and very informative risk assessments are completed for each resident. We have quoted this next section of the report from the last key inspection report as it is still applicable ‘ Health monitoring and promotion undertaken includes the monitoring of weights, as appropriate, and fluid balance. Acute interventions are recorded in relation to the each resident’s medical condition. Rehabilitative therapy is also recorded ’. As we have already mentioned in the report some residents do controlled exercise with the support of the rehabilitation staff in Shelley House. We saw good information in resident’s daily records about extra specialist health care support that residents may have while at the home. We checked in detail procedures for the administration, storage and disposal of medication to see if their safe systems in place. We checked medication administration charts of seven residents. We saw a photograph of the resident maintained with each record. We found that the charts were up to date, legible and contained the signature of the registered nurse staff dispensing the medication, as well as the reasons for any omissions. We saw written evidence that the home record if residents may have a sensitivity to medicines. This makes sure the health of the resident is protected. We checked the records for disposal of medicines and we could see that the home record this information and keep it up to date Medication to be given to residents is stored securely in a medicines trolley we also saw that the home has a fridge for medication that needs to be stored in this way. We checked the record of controlled drugs to see if this medicine is being given out safely. We saw that staff signatures for all medication that is given the amount of a controlled drug held corresponded with the amount recorded in the controlled drugs records. Shelley Park & Shelley House DS0000020492.V368560.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23.Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected from abuse. Resident’s complaints are taken very seriously by the home. EVIDENCE: We saw a copy of the homes complaints procedure. This is on display in the home and is clear and easy to follow. Four of the residents we met told us they knew whom they would speak to if they had a concerns or a complaint. We also saw evidence that showed the home use advocacy services if needed for residents who cannot directly express their views. We saw written evidence that showed that when complaints arise the manager deals with them promptly and thoroughly. We saw in each residents assessment records and care plans very helpful assessments that set out each residents possible risk of abuse both in and out of the home .The risk assessments we saw clearly guide people about the best ways to protect each resident. We saw in the training records that the staff do regular training in understanding the principles of protecting residents from abuse. Staff we met also confirmed for us that they had done regular training on this subject to help them to protect residents in their care Shelley Park & Shelley House DS0000020492.V368560.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30.Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in an environment that is satisfactorily clean and well maintained. Residents have the necessary adaptations and equipment in place to meet their needs. EVIDENCE: Shelley Park care home is an older Victorian property that is situated in a quiet suburb of the town of Bournemouth .The home is near to shops, a church, and local bus routes as well as the sea and it is a short drive from the motorway. Shelley Park is built over three floors and there is access by stairs and a lift to each floor. Shelley House, the rehabilitation unit that we have already mentioned, is located in a building in the grounds of Shelley Park at the bottom of the garden. Shelley House has level access and is used for rehabilitation activities. Shelley Park & Shelley House DS0000020492.V368560.R01.S.doc Version 5.2 Page 21 We found that the home looked reasonably homely and satisfactorily maintained. We saw that resident’s bedrooms had been made to look more personal with their own possessions, small items of furniture and photos and pictures on the walls. As was also applicable at the last key inspection and we have re quoted here from the report: ‘Shared rooms offer restricted space where there are two wheel chair users sharing; however, from observation of the environment, efforts are made to both maximise the use of space available and ensure that residents can be cared for safely. There are three rooms on one level, which are accessed by a stair lift and a ramp.’ We found all areas of the home that we saw were seen were clean and satisfactorily maintained. Shelley Park & Shelley House DS0000020492.V368560.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35.Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are cared for by a sufficient number of competent trained staff. Residents are protected by the home’s recruitment procedures. EVIDENCE: We checked the staff duty record for two weeks to see how many staff are on duty to support residents with their needs. We saw that there are two registered nurses on duty and at least twelve support workers on duty during the core hours of day as well as senior members of staff and staff working in Shelley House .In the afternoon there are two registered nurses and seven support staff. At night there are between four and five support workers and two registered nurses. There are also full time catering staff, domestic staff and maintenance staff employed although we did not review the number of these staff .We had a discussion with the on call manager about the numbers of staff .We observed that the number of staff who were on duty were meeting the needs of the residents. Shelley Park & Shelley House DS0000020492.V368560.R01.S.doc Version 5.2 Page 23 All of the staff we saw were seen helping and supporting the residents in a really sensitive way .We saw staff communicate with residents in a patient and kind way .We saw the staff take plenty of time to ensure that the care provided is done sensitively for the residents. The staff we met told us how much they enjoy working at the home. To find out if the home’s recruitment practises are safe we looked at four staff member’s employment records .We saw two references taken up for all new staff prior to offering work at the home. We also saw that staff complete a Criminal Records Bureau check, and a POVA1st check before starting at the home. These checks are a safeguard for vulnerable residents, to try and make sure only suitable people work in the home. We looked at the training records of two registered nurses and two care assistants to see if they are up to date with their knowledge and practice. We saw good evidence that demonstrated registered nurses had attended clinical training sessions, and updating over the last twelve months in matters relevant to residents range of very complex needs .We also saw some evidence that care staff have also attended relevant training in the home. Staff are provided with regular structured supervision sessions to assist them in their work and in better understanding residents needs. We looked at a sample of supervision records. These showed staff are monitored and the quality of their work is reviewed with them. Staff that we spoke to also told us that there are regular one to one supervision sessions with a senior ember of staff. Shelley Park & Shelley House DS0000020492.V368560.R01.S.doc Version 5.2 Page 24 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,41,42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ benefit from having experienced managers running the service. The home is run in their best interests. However there needs to be more robust system for handling residents’ money. Overall there are good systems in place to monitor the quality of care in the home. However improvements need to be made to the way that Regulation 26 unannounced monitoring visits are done. The heath and safety of residents and staff is protected. EVIDENCE: The on call manager who is a senior physiotherapist and works in Shelley House assisted us with the inspection. The families of two residents told us Shelley Park & Shelley House DS0000020492.V368560.R01.S.doc Version 5.2 Page 25 that we met how the on call manager is extremely committed and positive in their work with the residents. We spoke to the registered manager by phone, (they were on leave during the inspection). They offered to come to the home if needed. Based on our findings at the inspection we can see that the home is run with the best interests of the residents at the centre of the management of its service. We observed that the registered nurses on duty were providing leadership and guidance to the staff they were working with. We discussed with the on call manager the ways that they seek the views of people living in the home regarding the service that they receive. New ways of monitoring standards of care and the service have been introduced. Based on our discussions as well as some of the written information we saw we could see that the home are finding new, innovative ways of monitoring the care and the overall outcomes for residents. We saw the records of the monthly monitoring visits of the home that must be carried out by a representative of the people who own the home (this is a legal requirement). However we noticed that the registered manager is currently carrying out the visits .We advised the on call manager, that the visits must be done either by the registered provider or by a suitable representative on their behalf .We explained that the registered manager was not considered to be the suitable person to do these unannounced visits on the service, as they are in day to day charge of the home. We checked the finance records of three residents .The home hold residents money for safekeeping if needed .We could see when we checked the records that the cash and record totals are kept securely. However we saw that staff were not always signing for the money that they had taken out on residents behalf. We also saw that were not always receipts for items that had been bought on behalf of residents. We discussed this with the on call manager. We acknowledged that getting receipts for meals out in cafes and pubs can be difficult and can seem institutionalised. However we advised that there must still be a more robust and safe system in place for the handling and spending of residents’ money on their behalf. We observed that the staff who are directly involved in personal care were observed serving food to residents and going into the kitchen wearing suitable protective clothing over their uniforms to minimise the risks of cross infection from their uniforms onto food or surfaces in the kitchen. We saw the staff follow safe infection control practices. We observed staff wearing gloves and aprons when needed and washing their hands when they had carried out tasks. Shelley Park & Shelley House DS0000020492.V368560.R01.S.doc Version 5.2 Page 26 We saw in the training records that staff do regular training in areas of safe working practice, including fire safety, health and safety, and correct moving and handling techniques. Shelley Park & Shelley House DS0000020492.V368560.R01.S.doc Version 5.2 Page 27 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 Standard No Score 1 4 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 4 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X 2 3 X Shelley Park & Shelley House DS0000020492.V368560.R01.S.doc Version 5.2 Page 28 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA37 Regulation 26 Requirement The registered provider must do monitoring visits to the home: This requirement relates to the need for the unannounced monitoring visits to be done by either the registered provider, or someone suitable nominated on their behalf. Timescale for action 06/03/09 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 YA17 Good Practice Recommendations The home should seek the views (and should act on the findings) of residents and their representatives about the overall standards of the food provided. There must be a safer and more robust system in place for the handling and spending of residents’ money on their behalf. This requirement relates to the need to make sure residents’ money is handled safely at all times. [Schedule 4.9] DS0000020492.V368560.R01.S.doc Version 5.2 Page 29 2 YA41 Shelley Park & Shelley House Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: 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 © 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 Shelley Park & Shelley House DS0000020492.V368560.R01.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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