Inspection on 19/02/07 for Shenstone

This inspection was carried out on 19th February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Shenstone 24/07/07

Shenstone 09/02/06

Shenstone 23/03/05

Shenstone 14/12/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Shenstone Kent Road Halesowen West Midlands B62 8PQ Lead Inspector Christine Lancashire Unannounced Inspection 19th February 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Shenstone DS0000036811.V329707.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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Shenstone DS0000036811.V329707.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Shenstone Address Kent Road Halesowen West Midlands B62 8PQ 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) 01384 813470 01384 813471 trishaghaley-rose@dudley.gov.uk N/K Dudley Metropolitan Borough Council Mrs Trisha Ghaley-Rose Care Home 41 Category(ies) of Dementia - over 65 years of age (14), Old age, registration, with number not falling within any other category (27) of places Shenstone DS0000036811.V329707.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Day care provision must not encroach on the facilities, staffing and services provided to residential service users. That the category of one OPx1 to change to one MDEx1 reverting back to original category once the named service user ceases to live at the home. One service user identified in the variation report dated 11 May 2005 who is in the category PD may access the home’s respite services. One service user (male) identified in the variation report dated 12 August 2005 may be accommodated at the home in the category DE(E) who is aged 57 years and over. This will remain until such time that the service users placement is terminated at which time the registration will revert back to DE(E). One service user identified in the variation report dated 5 June 2006 who is in the category DE(E) may access the homes respite services. One service user identified in the variation report dated 5 June 2006 who is in the category MD(E) may access the homes respite services. 9th February 2006 5. 6. Date of last inspection Brief Description of the Service: Shenstone is a purpose built building of three - storey construction originally built in the 1960’s. It was refurbished in 1998 and is owned by Dudley MBC .It currently accommodates up to 41 service users. The building has 5 separate but interlinked units within the building of which one unit has 5 short stay beds for respite purposes, the remaining units having 9 beds. Each unit has its own kitchenette/ dining room lounge. Shenstone aims to provide 24 -hour care in a residential environment. The premises are light and airy and the décor and furnishings maintained to a good standard. All the windows are double-glazed. The home is situated on the main Kent Road close to nearby Blackheath and Halesowen Town centres. The fees for this home are £355 per week. Shenstone DS0000036811.V329707.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was undertaken on an unannounced basis on 19th February 2007 and concentrated on the key standards. The inspector spent four hours in the home and spoke with residents, staff and the manager. She also examined relevant records. The inspector left the home due to other commitments and returned on 14th March with a colleague to complete the inspection. The manager supplied written information in respect of the home and twenty seven questionnaires were completed by residents and their relatives. The information gathered is included in this report. What the service does well: What has improved since the last inspection? Shenstone DS0000036811.V329707.R01.S.doc Version 5.2 Page 6 There are improved security arrangements at the front door. The social care plans for residents have improved and there is now better recording in relation to activities. The staffing levels have improved. The managers have developed some additional policies and procedures and has reviewed and updated the Statement of Purpose. There are improved arrangements for ensuring that residents and their representative are aware of the complaints procedure. 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. Shenstone DS0000036811.V329707.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Shenstone DS0000036811.V329707.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,5,6 Quality in this outcome area is good. Prospective residents and their representatives have the necessary information to make an informed choice about where they live. They have the opportunity to visit to assess the quality of the home before moving in. No-one moves into the home without having their needs assessed and being assured that they will be met. This home does not provide intermediate care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a very detailed Statement of Purpose. This has been updated with current data and staff qualifications and the details of the Commission for Social Care Inspection. The Statement of Purpose supplements the service user guide which provides details about how to apply for a place, trial period, the situation of the home, the facilities and services available, the Shenstone DS0000036811.V329707.R01.S.doc Version 5.2 Page 9 arrangements for quality assurance and how to make a comment of complaint. Residents are also supplied with a welcome pack. Prior to admission, a detailed assessment is completed in the home or at the home of the prospective resident. The person is then invited to visit the home for a day or a meal. The manager is committed to ensuring that residents are involved in the process and make their own choice to enter the home. Relatives are welcomed to visit the home and assist the residents to make their choice. Many of the residents have previously attended the home for respite care and are familiar with the facilities and staff. One wrote, ‘I have been coming for respite stays for years so I know the home well’. Shenstone DS0000036811.V329707.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 Quality in this outcome area is good. Residents’ health needs are identified and set out in a suitable plan so that they can be fully met. Residents are protected by the home’s policies and procedures in respect of medication, but there is a need for improved storage arrangements. Residents feel that they are treated with respect and their dignity is upheld. Residents are assured that staff will treat them with sensitivity at the time of their death. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents’ health needs are identified prior to admission and are monitored on an ongoing basis. Residents may retain the services of their own GP if they are willing to do so. The manager reported some difficulties in registering residents with local GPs on occasions due to lists being full, but these difficulties are resolved. There are suitable policies and procedures in relation to the storage and administration of medication and the services of a local pharmacist are used to Shenstone DS0000036811.V329707.R01.S.doc Version 5.2 Page 11 oversee the system. However, the medication is stored on each unit in cupboards in the small kitchen areas. The cupboards are situated over toasters and kettles, so that the temperature often exceeds the optimum temperature for the storage of medication. Additionally, staff administering the medication have to reach over the hot appliances. At mealtimes, other staff are busy serving or clearing up and the area is crowded. The use of medication trolleys, which could be secured to the wall in an alternative location, would alleviate these problems and provide far more suitable storage. Residents confirmed that they are treated with respect and this was backed up by the inspector’s observations and staff comments. Their privacy is respected and those who wish to spend time in their rooms during the day are assisted to do so. However, staff are mindful of the possible isolation of residents and make regular checks to ensure that no-one becomes excluded from the home community. Residents are well presented and care is taken to ensure that they wear their own clothes, which are laundered with care. A separate folder is maintained with individual sheets containing details of the person to contact for each resident in case of emergency or death. The specific preferences of individuals are recorded, including detailed instructions for staff to follow where there are particular religious or cultural needs. Where there is no next of kin, a social worker’s telephone number is supplied. Shenstone DS0000036811.V329707.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. Residents find that their lifestyle in the home matches their expectations and preferences, meeting their needs. Residents maintain links on the community and are encouraged to exercise control over their lives. Service users receive a balanced diet in pleasant surroundings. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Social care plans are in place for each resident and the activities are arranged to take account of preferences expressed at residents’ meetings. Residents may move around the home and spend time on any unit should they wish to do so. Staff make efforts to ensure that there are activities available and examples of recent activities include card making and glass painting. Residents also play cards and chat with staff in addition to watching television and listening to music. There are plans to make Easter bonnets and to decorate egg cups. Some of the residents like to join in with the regular movement to music sessions which are led by alternating male and female visiting facilitators. Records are maintained of the activities in which residents participate and the manager continues to seek out new additions to the programme. Shenstone DS0000036811.V329707.R01.S.doc Version 5.2 Page 13 Periodic day trips are arranged, but these are not well attended as many residents are frail and prefer not to have the upheaval of using transport and going on a long journey. An example of this was a pantomime at Christmas, which residents did not attend. However, some outings have been well received and these include trips to Walsall illuminations, when relatives and friends also attend and help to push wheelchairs. The home has a garden and residents like to look at the wildlife, including birds, squirrels and badgers which emerge at night. Visitors are welcomed into the home at all times, but they are requested to avoid mealtimes if possible. Comments from relatives indicated that they are kept informed about important developments in the home. Residents’ views are sought at the time of admission and they are consulted regarding their daily care. They are encouraged to express their views at the time of reviews. Independence is promoted and residents are able to personalise their rooms. Information is available to residents and their relatives to enable them to access external agents such as advocates. The majority of residents indicated that they are satisfied with the food in the home. Meals are taken in the dining rooms on the units. Snacks are prepared in the small kitchens. Nutritional assessments are undertaken at the time of admission. If there are specific dietary requirements, these are recorded and food charts are used for residents who are experiencing food related difficulties. Residents are weighed. 95 of the staff team have recently completed nutrition training and the manager is seeking to improve the content of the meals. The menus have been taken to a dietician for comments and there are plans to provide greater choice. Mindful of the need to ensure that all residents are adequately hydrated, there are frequent drinks, increased use of food which has a higher fluid content and smoothies. There have always been baskets of fruit around the home, but now cut fruit is being offered on the lunchtime trolley and this is more accessible for residents. This has been a popular development. Shenstone DS0000036811.V329707.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18. Quality in this outcome area is good. Residents and their representatives are confident that their complaints will be listened to and acted upon. Residents are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a detailed complaints procedure, which is made available to residents, their relatives and representatives. This is included in the welcome pack. Residents and their relatives confirmed that they would be aware of the action to take should they be dissatisfied with any aspect of the home. Information was made available in relation to complaints. One complaint was investigated by the home’s line manager and resolved. The staff and manager respond to other informal comments and examples were provided of action, which had been taken in relation to comments received. One relative wrote, ‘Senior staff are always approachable and responsive immediately to any concerns’. All staff have received training in adult protection during the first six months of their employment. The subject is also covered as part of the Skills for Care induction. There are procedures in relation to confidentiality, adult protection and whistle blowing and these are made known to staff. Examples were provided of action which had been taken in order to safeguard the well being of residents in line with good practice. Shenstone DS0000036811.V329707.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is good. Residents live in a safe and well-maintained home which is clean and hygienic. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are a total of 5 units, all of which have their own kitchen, lounge, dining bath and toilet facilities. There are a total of 15 assisted toilets and six assisted bathrooms. There is a lift and ramps available and handrails are placed throughout the home. There is a garden to the rear of the home. The home was found to be clean, with no unpleasant odours. All areas are reasonably well maintained and there is a programme to ensure that maintenance takes place. The manager has identified a need for some of the borders to be replaced or repaired and the maintenance worker will attend to these in the week after the inspection. There is currently only one maintenance worker shared between 9 homes and this means that he is very Shenstone DS0000036811.V329707.R01.S.doc Version 5.2 Page 16 busy and jobs do not always get completed quickly. Larger jobs are undertaken by Dudley DPC. In the opinion of the inspector, the hours allocated to this post should be reviewed. The home has good systems for ensuring that the home is safe and there are no obvious health and safety hazards. There are infection control procedures, which are known and practised by staff. Each unit has a good supply of gloves and aprons. Suitable procedures are followed in respect of the laundry. There are improved security arrangements to the front door since the last inspection. Security is also improved by the use of key codes to the lift and on the stairwells. The manager is exploring the possibility of dividing the garden so that it is safer for residents. Shenstone DS0000036811.V329707.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. Quality in this outcome area is good. Residents’ needs are met by the numbers and skill mix of staff and they are protected by the recruitment policies and practice. Staff are suitable trained and competent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff are recruited according to the council’s standard procedures. These include taking up references and ensuring that Criminal Records Bureau checks are undertaken. Sampled staff files contained the necessary details. The rotas show an adequate level of staff cover, which has improved since the last inspection. The staffing levels have been reviewed and the levels increased so that there are now two members of staff on each unit. Cover is maintained during periods of sickness with the use of regular agency staff. Where individual residents have specific staffing needs, these have been met by agency staff, but this has been reviewed so that permanent staff will now be recruited for this purpose. The manager is supported by a team of senior staff, one of whom reviews the care plans two days each month. 53 of staff have attained level 2 NVQ and 4 more are about to compete this level. These figures do not include the senior staff, all of whom have attained level 4. The manager has completed the Registered Managers’ Award. There are ongoing opportunities for staff to attend courses in relevant areas and to update previous training. Shenstone DS0000036811.V329707.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38. Quality in this outcome area is good. Residents live in a home which is run by a person who is suitable and able to undertake her responsibilities fully. The home is run in the best interests of the residents and their financial interests are safeguarded. The health, safety and welfare of residents, staff and visitors is promoted and protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager is well qualified and experienced to undertaken her role. Having completed the Registered Managers’ Award thee years ago, she has continued to undertake training relevant to her role. She has just completed the examination for the Safe Handling of Medicines level 2 and is a trainer instructor for manual handling. She has an enthusiastic approach towards extending her skills and experience. Shenstone DS0000036811.V329707.R01.S.doc Version 5.2 Page 19 Dudley MBC implements a quality assurance system which evaluates the home against the standards and is accessible electronically. An analysis is also undertaken in relation to complaints and accidents. A medication audit has recently been completed. The views of residents, staff and relatives are sought in order to improve the service. Since the last inspection, the home has developed a policy in relation to sexuality and relationships, which reinforces good practice in these areas. The manager is now working on a policy covering the values of privacy, dignity, choice, fulfilment, rights and independence. There are suitable procedures to guide good practice in relation to Health and Safety. Staff receive training in manual handling, basic first aid and food hygiene. Records are kept of accidents and incidents. A COSHH folder is maintained and updated when new products are used. There are good arrangements for infection control and staff have easy access to gloves and aprons. Risk assessments are carried out in relation to the premises and the residents. There are regular checks on services to and equipment in the home. There are regular fire drills and all fire fighting and detection equipment is checked regularly. There is a current 5-year electrical wiring certificate and all portable appliances are tested on receipt and at regular intervals. There are financial procedures which safeguard residents. The budgets for the home are reviewed on a monthly basis. Shenstone DS0000036811.V329707.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 4 X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Shenstone DS0000036811.V329707.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No 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 OP9 Regulation 13 Requirement The manager must ensure that the medication is stored in a location which can be maintained at the required temperature. Timescale for action 01/06/07 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 2 Refer to Standard OP9 OP19 Good Practice Recommendations It is recommended that use is made of medication trolleys on each floor. It is recommended that the manager should review the hours allocated for maintenance work in the building. Shenstone DS0000036811.V329707.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Halesowen Record Management Unit Mucklow Office Park, West Point, Ground Floor Mucklow Hill Halesowen West Midlands B62 8DA 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 Shenstone DS0000036811.V329707.R01.S.doc Version 5.2 Page 23 - 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. 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