Inspection on 16/03/06 for Sherdley Court

This inspection was carried out on 16th March 2006.

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

Sherdley Court 02/07/07

Sherdley Court 30/11/06

Sherdley Court 09/01/06

Sherdley Court 23/03/05

Sherdley Court 31/08/04

Sherdley Court 05/03/04

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

CARE HOMES FOR OLDER PEOPLE Sherdley Court 91 Rainhill Road Rainhill Merseyside L35 4BD Lead Inspector Miss Diane Sharrock Unannounced Inspection 16th March 2006 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 Sherdley Court DS0000022410.V287698.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Sherdley Court DS0000022410.V287698.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Sherdley Court Address 91 Rainhill Road Rainhill Merseyside L35 4BD 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) 0151 4263096 0151 4939382 Making Space Hayley Rowson de Vares Care Home 25 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (19) Sherdley Court DS0000022410.V287698.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 9th January 2006 Date of last inspection Brief Description of the Service: Sherdley Court is a 25-bedded care home for people with a mental disorder. It is registered to accommodate 19 service users over the age of 65 years and 6 under 65 years. It is owned by a charity, Making Space and the Manager is Mrs Haley Rowson de Vares. It is a purpose-built facility on one floor. It is divided into three units, each with its own lounge and dining area as well as bedroom space. Each bedroom is for single occupancy. The care home also has a large communal lounge area as well as a conservatory, which is used as a smoking room. There is a rehabilitation kitchen, which has been refurbished to the highest standards. Sherdley Court has two rooms for management purposes and a well-appointed kitchen and laundry. It is not registered to provide nursing care but when necessary calls on nursing services, via the district nursing and community psychiatric nursing services. The care home is fully equipped with grab rails and other aids to assist disabled service users manage the premises. It has a call system located throughout the building. The care home integrates easily into the local environment being of a pleasant appearance with accessible garden areas. Sherdley Court is located in an established residential area of St Helens with easy access to local facilities. Sherdley Court DS0000022410.V287698.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced. Information for the inspection was gathered in a number of ways, this included, a tour of the building, informal discussion with some of the residents and reading records and documents in the home. A selection of comments cards were also left in the home. What the service does well: What has improved since the last inspection? The home have recently purchased a computer this provides access to on-line shopping and is available for residents to use. The home have a rehabilitation kitchen, which is fitted to a high standard and is well used by residents. Since the last inspection several areas have been redecorated to a good standard. Record keeping in the home continues to improve, with clear care plans in place for residents daily lives. The home have also introduced a new welcome pack. This is well designed with information easy to access and understand. The information kept in staff files has also been improved with the addition of identification photographs for new staff. Recent training in the home has included, the protection of vulnerable adults and equality and diversity. Sherdley Court DS0000022410.V287698.R01.S.doc Version 5.1 Page 6 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. Sherdley Court DS0000022410.V287698.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Sherdley Court DS0000022410.V287698.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Pre – admission assessments are carried out prior to a resident choosing to live in the home. EVIDENCE: A review of one residents records showed a detailed assessment carried out prior to their admission. This helped the home to determine that they could meet the person’s needs. In discussion with the manager it was determined that a detailed care plan was not in place as the person was still in their trial period. This should be reviewed and an appropriate care plan, agreed by the resident, should be in place. This should give enough detail for staff to support the resident with their needs. Sherdley Court DS0000022410.V287698.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): X These standards were not looked at during this inspection. EVIDENCE: Sherdley Court DS0000022410.V287698.R01.S.doc Version 5.1 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14 & 15 There are many examples of the way in which the home supports people to take control of and make choices in, their lives. Residents were complimentary of the food and menus offered. EVIDENCE: The home have recently installed a computer with Internet access in the main lounge. The manager intends to arrange computer lessons and explained a recent initiative, whereby an account has been set up with a local supermarket. Residents now have access to this account so that they can order according to their choices, particularly food. There were many examples of how residents are supported in their choices of daily lifestyle, with some going out regularly to work or visiting. The menus have recently been developed. Minutes of a residents meeting showed that this had been done by residents, who had the opportunity to change the menu based on their individual preferences Sherdley Court DS0000022410.V287698.R01.S.doc Version 5.1 Page 11 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 Training records and polices make it clear that staff are informed how to protect residents. EVIDENCE: Staff training records reviewed since the last inspection showed that all staff at the home have had recent ‘abuse awareness training’. Staff files are kept in accordance with regulations, with the manager holding an up to date list of police checks (CRB) for all staff employed at the home. Sherdley Court DS0000022410.V287698.R01.S.doc Version 5.1 Page 12 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 The home is very well maintained and was clean and tidy during this unannounced inspection. EVIDENCE: The home, yet again evidenced that it provides a high standard of living, with recent refurbishment to all 3 lounge / dining areas. Residents and staff had input to their own colour schemes in each area. The rehabilitation kitchen has been refurbished to a high standard. Staff explained that that it is new in operation with some residents being supported in preparing meals for their relatives. The outside areas are also included in the on-going maintenance and investment planning for the home, with each communal area having an attractive outlook to well maintained garden areas. The conservatory is used as the smoking area and has recently been refurbished which enhances the environment further. Sherdley Court DS0000022410.V287698.R01.S.doc Version 5.1 Page 13 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 & 30 The numbers of staff on each shift are clearly advertised and reviewed by the management. Staff files are reviewed and kept as necessary with the information required by the Care Homes Regulations 2001. Staff training records have been revised and show clear, updated information for all members of staff. EVIDENCE: The homes statement of purpose has been reviewed since the last inspection. The manager has now displayed the number of staff, for each shift that the company have committed to providing. These documents are clearly displayed and accessible in the main reception area. Staff rotas reflected the usual staffing levels. Personnel files are very organised and detailed with all necessary records and checks including police (CRB) and Protection of Vulnerable Adults (POVA) checks. Staff training records are up to date and clear with a visual training matrix displayed in the managers office. This gives details of recent training in 2006, including a course for staff on equality and diversity. Sherdley Court DS0000022410.V287698.R01.S.doc Version 5.1 Page 14 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33 & 35 The home is very well managed with lots of examples of residents benefiting from the ethos and management approach, it is clear the home is run in the best interests of residents. Personal allowances are well managed and documented with up to date records kept. EVIDENCE: The manager offers a very high standard of management and ethos in how she involves all parties in making decisions about their home. There are regular minuted meetings to keep people informed. These also offer ways for all parties to give their opinions about developments in the home, recently this has included changes to the menus, use of the computer, the refurbishment plan and daily activities plan. A recent quality assurance check involved the use of questionnaires, which have given a very positive input from all parties. The company and manager are to summarise the results and publish them, providing this information for all concerned. Sherdley Court DS0000022410.V287698.R01.S.doc Version 5.1 Page 15 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 4 X X X X X X 4 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 3 3 X 3 X X x Sherdley Court DS0000022410.V287698.R01.S.doc Version 5.1 Page 16 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7OP8 Good Practice Recommendations The Responsible Person must ensure that care plans are developed to meet standards7 & 8 in full. Sherdley Court DS0000022410.V287698.R01.S.doc Version 5.1 Page 17 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: 0845 015 0120 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 Sherdley Court DS0000022410.V287698.R01.S.doc Version 5.1 Page 18 - 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. 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