Inspection on 18/09/07 for Sherwood

This inspection was carried out on 18th September 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

Sherwood 18/10/06

Sherwood 04/01/06

Sherwood 17/08/05

Sherwood 08/02/05

Sherwood 29/09/04

Sherwood 17/03/04

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Ruskin Lodge

Dystlegh Grange

The Good Companions

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Cuerden Grange Rest Home

Cornmill Nursing Home

Vitalise Sandpipers Centre

Sue Ryder Care Birchley Hall

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

CARE HOMES FOR OLDER PEOPLE Sherwood Clifton Street Rishton Nr Blackburn Lancashire BB1 4DW Lead Inspector Mrs Susan Hargreaves Unannounced Inspection 18th September 2007 11:30 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 Sherwood DS0000052306.V345239.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. Sherwood DS0000052306.V345239.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sherwood Address Clifton Street Rishton Nr Blackburn Lancashire BB1 4DW 01254 829816 01254 829816 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) Mrs Maria Goretti Timmins Vacant post Care Home 6 Category(ies) of Physical disability (2), Physical disability over 65 registration, with number years of age (6) of places Sherwood DS0000052306.V345239.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The service should, at all times employ a suitably experienced and qualified manager who is registered with the Commission for Social Care Inspection A maximum of 6 service users requiring personal care who fall into the category of PD(E) Within the total number of 6, a maximum of 2 service users requiring personal care who fall into the category of PD. It is recommended that the registered manager have a job description that clearly outlines their responsibilities and areas of authority in line with the requirements of the Care Homes Regulations 2001. 18th October 2006 Date of last inspection Brief Description of the Service: Sherwood House is a large 2 storey terraced property situated in the small town of Rishton and close to shops and local amenities. The home offers 24-hour personal care for up to 6 people who have a physical disability and require intermediate care. Staff at Sherwood House work in partnership with Lancashire Council Social Services and the National Health Service to provide a rehabilitation programme for the residents. Accommodation is provided in single en-suite rooms on both floors of the home. Access to the first floor is via a stair lift. Communal rooms consist of a lounge, dining room and kitchen. Residents usually stay at the home for about 6 weeks. During this time independence is promoted and progress reviewed weekly. Social services are responsible for placing and funding all residents at Sherwood House. Additional charges are payable for hairdressing, newspapers, and toiletries. A statement of purpose and service user guide is available on request. Sherwood DS0000052306.V345239.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key unannounced inspection, which included a visit to the home, was conducted at Sherwood on the 18th September 2007. No additional visits have been made since the last inspection. Three completed surveys were received from residents and one from the relative of a resident. At the time of this inspection 2 residents were living at the home. A tour of the premises took place and staff files and care records were inspected. Members of staff on duty, residents and a visiting physiotherapist were spoken to. Discussions also took place with the manager regarding issues raised during the inspection. What the service does well: All the residents who completed the survey ticked the box indicating that they always received the care and support they needed. One resident wrote on the survey, ‘I was quite happy there and did well. I came out much better than when I went in.’ The relative of a resident said over the telephone, “They really looked after my mother, they got her walking within two weeks. Everyone was friendly, mum was very happy there.” During the inspection one resident said, “The staff are helpful, friendly and they look after us.” This resident went on to say, “if you want a cup of tea in the night just ring and they’ll bring you one.” The visiting physiotherapist explained that staff were helpful and encouraged residents to follow their exercise programmes. Visitors were welcomed into the home at any reasonable time and offered refreshments. Both residents said the meals were good. One resident said, “I’ve just had a bacon butty.” Sherwood DS0000052306.V345239.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Sherwood DS0000052306.V345239.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 Sherwood DS0000052306.V345239.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): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A thorough admissions procedure ensured sufficient information was obtained in order to identify the needs of each resident. EVIDENCE: Admission to the home, for all residents, was arranged by social services. The care records of one resident were inspected. These records contained a detailed pre-admission assessment, which had been completed by a social worker from the intermediate care team. This assessment provided useful information for the care plan. The intermediate care programme lasted for about 6 weeks and was delivered by the multidisciplinary team. This involved frequent visits from healthcare professionals including physiotherapists and occupational therapists. A visiting physiotherapist said that members of staff were helpful and ensured residents followed their exercise programme. Sherwood DS0000052306.V345239.R01.S.doc Version 5.2 Page 9 The multidisciplinary team reviewed progress within the rehabilitation programme weekly. The multidisciplinary team also provided any necessary equipment. Sherwood DS0000052306.V345239.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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The personal and healthcare needs of each resident were identified and met. Medication was managed safely. EVIDENCE: The care plan of one resident was inspected. This plan identified the care needs of the resident and explained how these needs were to be met. Appropriate risk assessments had been carried out. The resident had been involved in the preparation of this care plan. A written report about the care given to individual residents was completed everyday. The manager was advised to ensure this was also done every night. Residents were registered with a GP and had access to other healthcare professionals. Sherwood DS0000052306.V345239.R01.S.doc Version 5.2 Page 11 Members of the intermediate care team recorded details of their visits and provided written instructions for the care staff to follow. Residents were involved in the reviews of their progress within the rehabilitation programme. Records for the management of medication were seen to be up to date. However, hand written instructions on the medicines administration records were not signed or witnessed. Medication was stored in a locked cupboard in the office. The temperature of this area was checked and recorded daily. Appropriately trained senior members of staff were responsible for administering all medication. The manager explained that a new member of staff was working some night shifts. This care worker had not been trained in the management of medication and was therefore not allowed any access to medication. This meant residents could not have medication prescribed when required e.g. paracetamol unless a senior member of staff was contacted. The manager was advised to arrange training in the management of medication for all night staff in order to ensure residents could have their medication at the time they needed it. Personal care was carried out in private. Members of staff were observed talking to residents in a friendly and professional manner. Two members of staff explained in detail how they promoted privacy and dignity for all residents. One resident said, “The staff are helpful and friendly.” Sherwood DS0000052306.V345239.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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Independence was promoted and residents were supported to have a fulfilling lifestyle. EVIDENCE: Residents were encouraged to pursue their own interests and hobbies. However, a variety of leisure activities were provided. These included draughts, bingo, dominoes, scrabble, snakes and ladders, creative arts, armchair exercises, visits to the local shops, short walks and watching television. One residnet wrote on the survey, ‘I enjoyed playing dominoes and the staff did as well.’ Discussion with residents and staff confirmed that the daily routine was flexible. Residents choose when to get up and go to bed. Visitors were welcomed into the home at any reasonable time. Both residents said the meals were very good. Menus were planned on a daily basis when the residents had been asked what they wanted to eat. Residents Sherwood DS0000052306.V345239.R01.S.doc Version 5.2 Page 13 were encouraged to prepare light meals for themselves e.g. breakfast as part of the rehabilitation programme. Sherwood DS0000052306.V345239.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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents felt able to express their concerns. Staff had the training necessary to ensure residents were protected adults. EVIDENCE: A copy of the complaints procedure was displayed in the home and included in the service user guide. No complaints have been made to the home or the commission since the last inspection. Policies and procedures relating to the safeguarding of vulnerable adults were in place. However, the procedure needed amending to clearly state the action to be taken if allegations of abuse were made. This issue was discussed with two members of staff. They were aware of the procedure and said they would report any concerns immediately. Training in safeguarding vulnerable adults is included in the induction programme for new employees and NVQ level 2. Sherwood DS0000052306.V345239.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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The premises were well maintained and provided a comfortable and ‘homely’ environment for the residents. EVIDENCE: At the time of the inspection the home was clean, tidy and well maintained. To improve the premises a new carpet was fitted in the hallway in July. Laundry facilities were located in the kitchen. These were suitable for the size of the home and the needs of the residents. An infection control policy was available. Sherwood DS0000052306.V345239.R01.S.doc Version 5.2 Page 16 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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Members of staff were encouraged to acquire the skills and knowledge needed to provide effective care for the residents. Recruitment procedures were thorough. EVIDENCE: Examination of the duty rota confirmed that a sufficient number of staff were on duty for all shifts to ensure the needs of the residents were met. A senior member of staff was on call for emergencies during the night when only one care assistant was on duty. The file of one care worker appointed since the last inspection was examined. This indicated that all the required pre-employment checks to ensure protection of the residents had been completed prior to appointment. It was evident from discussion with the manager and two care workers that training was encouraged. This included, induction training for new employees, moving and handling, basic food hygiene, fire safety and first aid. Four care workers had an NVQ level 2 in care and three were working towards this qualification. Sherwood DS0000052306.V345239.R01.S.doc Version 5.2 Page 17 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 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a competent manager. The views of residents are considered when decisions about the care and facilities provided at the home are made. EVIDENCE: The recently appointed manager has experience of caring for older people requiring intermediate care. She has successfully completed the first year of a foundation degree in health and social care following the rehabilitation pathway. She also keeps up to date with current practice by reading a variety of care journals and using the Internet. One care worker said the manager was helpful and supportive and staff morale had improved following her appointment. A visiting physiotherapist explained how communication had improved and the manager always discussed any concerns. Sherwood DS0000052306.V345239.R01.S.doc Version 5.2 Page 18 The home has achieved the nationally accredited Investors in People award. This was successfully reassessed in July this year. Residents were asked to a complete quality survey on discharge. Resident’s meetings were held every month. Minutes of the meetings held in July and August were available. At these meetings residents discussed the meals and one lady had asked for and was supplied with a table in her room for doing jigsaws. Relatives were encouraged to discuss any aspect of the service provided with the manager at anytime. Meetings with the intermediate care team were held every six months. Feedback about the care and rehabilitation programme was given and future plans discussed. Minutes of the meeting held on 13 September were available. Both the residents were able to accept responsibility for their own money. Policies and procedures relating to safe working practices were in place. A fire risk assessment had been carried out. Fire alarms and emergency lighting were tested weekly. The last fire drill was held on 26 July when a full evacuation of the home had taken place. Records of the routine servicing of equipment were seen. These included up to date electrical installation and gas safety certificates. The manager explained that arrangements had been made for the testing of small electrical appliances. This was last done in August 2006 and should be carried out annually. Records maintained in the kitchen included fridge and freezer temperatures. Safety procedures were displayed throughout the home. Sherwood DS0000052306.V345239.R01.S.doc Version 5.2 Page 19 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 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X 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 2 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 Sherwood DS0000052306.V345239.R01.S.doc Version 5.2 Page 20 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. 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 2 Refer to Standard OP9 OP9 Good Practice Recommendations All hand written instructions on the medicines administration records should be signed and witnessed. To ensure residents can have their medication when required all night staff should have training in the management of medication. The procedure to follow if allegations of abuse are made should be amended to clearly state what action must be taken. 3 OP18 Sherwood DS0000052306.V345239.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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 Sherwood DS0000052306.V345239.R01.S.doc Version 5.2 Page 22 - 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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