Inspection on 14/04/05 for Sherwood Court

This inspection was carried out on 14th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 Court 09/07/08

Sherwood Court 01/08/07

Sherwood Court 26/02/07

Sherwood Court 08/05/06

Sherwood Court 07/10/05

Sherwood Court 03/11/04

Sherwood Court 28/07/04

Sherwood Court 02/03/04

Similar services:

Claremont House

Coopers Mill Ltd

Sun Court Nursing Home

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Paradise Lodge

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Upaya Ananda

15 Bramble Close

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

CARE HOME ADULTS 18-65 Sherwood Court The Common Hatfield Hertfordshire AL10 0NX Lead Inspector Yoke-Lan Jackson Unannounced 14 April 2005 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 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 Stationary 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 Court I52_s19524_Sherwood Court_v221042_140405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Sherwood Court Address The Common, Hatfield, Hertfordshire, AL10 0NX Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01707 262405 01707 259563 Caretech Community Service Limited CRH Care Home 8 Category(ies) of LD - 8, LD(E) - 8, PD(E) - 8 registration, with number of places Sherwood Court I52_s19524_Sherwood Court_v221042_140405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 03/11/04 Brief Description of the Service: Sherwood Court is a residential care home for eight service users with learning and physical disability. The Provider is CareTech Community Service Limited. The building, a bungalow, is situated in the town of Hatfield. It is within walking distance of the supermarket, local shops, and public transport. There is a small parking area in the front of the building. The communal areas are limited to the lounge and a dinning room. The fitted kitchen is of average size. The bedrooms are situated to one side of the building. The shared assisted bathrooms and toilet facilities are nearby. There is a laundry room next to the office. The lounge overlooked a small courtyard that has a patio with garden furniture and plants. All the rooms, corridors and the patio are accessible to wheelchairs. Sherwood Court I52_s19524_Sherwood Court_v221042_140405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection (Unannounced) was the first for the year 2005. It took six hours. The inspection centred on environmental health and safety issues, medication, activities, and general observation of staff performance and interaction with the respective service users. Since the last inspection, the acting manager has been replaced. The new acting manager had been in post three weeks preceding this inspection. The staff spoken with said that staff morale had been low prior to the change of management. However, the personal care of the service users have been maintained. The general appearance, expressions and gestures from the individual service users suggested that they have been cared for in a positive way. The service users are not able to give verbal feedback because of their learning disability. The inspection has identified areas of concern, regarding storage facilities, hazardous substances and other environmental hazards. The administrative process and the maintenance of services have been inconsistent and there is poor record keeping. The premises have not been maintained in a consistent way. The new acting manager is aware of current shortfalls in the service and the challenging tasks that lie ahead. In the short period that she has been in post, she has identified areas of concern and she has taken steps to remedy the situation. (Since this report was written, the current acting manager has been appointed as the home manager for Sherwood Court, subject to six months probationary period). What the service does well: The personal care and assistance provided to the individual service users have been maintained in spite of the lack of an effective leadership. The service users appeared well cared for. The staff members spoken with were keen and committed to caring and supporting the individual service users in their care. One staff remarked: “Whatever happened at management level, I enjoy looking after the residents so they are not affected”. Sherwood Court I52_s19524_Sherwood Court_v221042_140405 Stage 4.doc Version 1.20 Page 6 What has improved since the last inspection? What they could do better: The standard of the services has been affected by a lack of effective leadership. The members of staff need clear direction in the day to day operation of the services to ensure that the health, safety and welfare of the service users are not affected in a negative way. The premises must be maintained and kept clean and tidy in a consistent way. The external ground must be free from hazards to safety. It must be accessible to the service users and wheelchair users at all times. The patio and back garden could be more attractive in appearance. The members of staff need to be more aware of hazards to health and safety. Refresher courses must be arranged for all staff to attend training on COSSH and Health and Safety. Records required by legislation regarding the services must be kept up to date and be readily available for inspection. A system must be in place to ensure that a risk assessment is carried out prior to the purchase of furniture (and other items) to ensure that the service users and staff are not exposed to risk of physical injury. Sherwood Court I52_s19524_Sherwood Court_v221042_140405 Stage 4.doc Version 1.20 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Sherwood Court I52_s19524_Sherwood Court_v221042_140405 Stage 4.doc Version 1.20 Page 8 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 Standards Statutory Requirements Identified During the Inspection Sherwood Court I52_s19524_Sherwood Court_v221042_140405 Stage 4.doc Version 1.20 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 The new manager has begun the process to ensure that prospective service users aspirations and needs are identified and assessed. EVIDENCE: There is a prospective service user who is interested in moving into the home. The admission process is being carried out. A trail visit has been arranged and the new manager must ensure that the prospective service user admitted to the home has a full assessment to ensure that her needs can be met. Sherwood Court I52_s19524_Sherwood Court_v221042_140405 Stage 4.doc Version 1.20 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 & 7 The members of staff assisted the service users in all aspects of life in the home. The individual needs are being met. All personal information is kept safe in the office. Confidentially is maintained. EVIDENCE: All the service users have severe learning disability. Some have physical disabilities and are wheelchair users. Their ability to participate in the day to day running of the home is therefore limited. However, opportunities and choices are given in the course of the daily living routine. One service user tends to move around on the floor. She was given access to all the communal areas subject to risk assessment for her own safety. It was noted that one wheelchair user was consulted before he was assisted to his bedroom, providing an example of how staff work with service users rather than do things for them. Sherwood Court I52_s19524_Sherwood Court_v221042_140405 Stage 4.doc Version 1.20 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 & 16 The service users’ rights are respected. There is good interaction between the members of staff and the service users. The members of staff communicated in an appropriate manner, using the individual preferred mode of communication. None of the service users are able to communicate verbally. The activity programmes are restricted for some of the service users who have physical disability. However, opportunities and choices are given. The service users are engaged in leisure activities in the local community. EVIDENCE: Three of the service users were at the Day Care Centre. Three others had lunch out in the local shopping centre, accompanied by staff. One service user remained in the home. A member of staff prepared the cooked lunch for him and assisted him at mealtime. The weekly menu is on display in the kitchen. Staff members take turns to prepare the meal. Sherwood Court I52_s19524_Sherwood Court_v221042_140405 Stage 4.doc Version 1.20 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 19 & 20 The service users appeared neat and clean. They were treated with respect and dignity. All the service uses are given personal support and assistance by staff. The home must comply with the legislation for the safe storage and administration of medicines. The home must purchase an additional drug cupboard that can be used to store controlled drugs. (Please see Statutory Requirements). EVIDENCE: All the service users require personal care and assistance. The home operates the key-working system so that there is continuity of care for the individual service user. All the service users were in their own clothes. The service users are not able to administer their own medication. Staff recently attended additional courses on “The Safe Handling and Administration of Medication”. On the day of the inspection, it was discovered that some medicines were stored in a locked wooden cupboard in the laundry room where the temperature may not have been below 25 degrees Centigrade. Immediate action was taken by the manager to re-arrange all medicines in the drug cupboard in the office. The controlled drug that was recently prescribed was removed and stored in a locked metal box in the drug cupboard until the home purchase a drug cupboard that is designed to store controlled drugs. Sherwood Court I52_s19524_Sherwood Court_v221042_140405 Stage 4.doc Version 1.20 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 A system is in place to safeguard the service users from abuse, neglect and self-harm. EVIDENCE: The home has a copy of the Hertfordshire Adult Protection Policy and Procedure. The members of staff are aware of the Whistle Blowing Policy. Proper financial records are kept at head office and copies of bank statements are attached to the individual service user files. The acting manager oversees their personal allowances and proper accounting records are kept. Sherwood Court I52_s19524_Sherwood Court_v221042_140405 Stage 4.doc Version 1.20 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 & 30 The home does not currently provide a safe, clean and comfortable environment for the service users. The carpet in the lounge is stained. The external grounds must be consistently maintained and kept clean and tidy. It is recommended that the home employ a part-time gardener. A risk assessment must be carried out for all furniture to ensure that service users and staff are not exposed to risk of physical injury. If necessary, the occupational health therapist or physiotherapist should be consulted. EVIDENCE: The interior of the premises has been recently re-decorated. However there are objects and ornaments left in the lounge covered in dust. Part of the carpet in the lounge is severely stained and it appeared to be mouldy. Empty plastic containers were left piled up in one corner of the corridor outside the office with other objects on top. The external ground, patio and back garden have not been kept tidy, safe and clean in a consistent way. One of the old wooden poles (with nails visible) has not been removed since the last inspection. The old garden furniture were positioned in an untidy position. A bottle filled with water and cigarettes was left on top of the garden table. By the French door was an old electrical mat Sherwood Court I52_s19524_Sherwood Court_v221042_140405 Stage 4.doc Version 1.20 Page 15 with wires exposed. One of the roof tiles may need to be replaced. A section of the gutters is bent. All the bedrooms were checked. They appeared clean and some appeared tidy. However, the design of the bed of one service user may expose the service user and members of staff to physical injury. A risk assessment was not carried out at the time of purchase of the bed. The new manager has identified the risk and she has taken steps to rectify the situation. Sherwood Court I52_s19524_Sherwood Court_v221042_140405 Stage 4.doc Version 1.20 Page 16 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33 & 35 The lack of a suitable manager in recent months has had a negative effect on staff morale, which may ultimately affect the service users’ health, welfare and safety. The staff roles and responsibilities need to be reviewed so that all staff can participate in making the premises more homely, clean and safe for the service users. Teamwork should be encouraged. The home complies with legislation with regard to recruitment procedures, including police checks and the Protection of Vulnerable Adult (POVA) checks. EVIDENCE: There is an increase in the number of bank staff since the last inspection. This solved the staffing problem. The two new staff commenced work following police checks and POVA checks. They are currently undergoing induction training as specified in the Induction Package. The members of staff spoken with enjoy their work in caring for and supporting the service users. They admit that the lack of a suitable manager has affected staff morale. However, they look forward to working with the new manager. Sherwood Court I52_s19524_Sherwood Court_v221042_140405 Stage 4.doc Version 1.20 Page 17 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 39 & 43 The services have been affected by the lack of an effective leadership. The management must ensure that all essential services and disability equipment are regularly serviced. All records required by legislation for the effective running of the services must be maintained, be up to date and be accurate. The records required by legislation must be readily available for inspection. The management must ensure the health, safety and welfare of the service users in the home. The members of staff need to be more aware of hazards to health and safety. It is recommended that refresher courses on COSSH and Health and Safety be arranged for all staff to attend. The management must ensure compliance with legislation regarding the storage of cleaning products and hazardous substances. (Please see Statutory Requirements). Sherwood Court I52_s19524_Sherwood Court_v221042_140405 Stage 4.doc Version 1.20 Page 18 EVIDENCE: The home has been unsuccessful in recruiting a suitable home manager since July 2004. Staff morale were affected. The current Acting Manager has been in post three weeks preceding this inspection. She is aware of the shortfalls and the challenging tasks ahead. She has taken steps to improve the management and administrative processes. One to one staff supervision has been completed. A structured staff meeting has been conducted. It was noted that records were not readily available for inspection in regards to the servicing of the fire extinguishers. There was no evidence as to when the fire equipment had been serviced. Similarly there is no record as to when the wheelchairs had been serviced or re-assessed for suitability. The new manager has identified the risk for one wheelchair user. She has made arrangement to meet with the social services involved in the care package for the service user. All the cleaning products and hazardous substances kept in the laundry room were left exposed. The broken door of the storage cupboard is waiting to be repaired. On the day of the inspection immediate action was undertaken by staff to remove the hazardous substances to a secured and locked room until the cupboard is repaired. The laundry room was cleared of unwanted objects at the same time. 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. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: Sherwood Court I52_s19524_Sherwood Court_v221042_140405 Stage 4.doc Version 1.20 Page 19 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 3 3 x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 3 2 x 1 2 2 Standard No 11 12 13 14 15 16 17 x 3 3 3 x 3 3 Standard No 31 32 33 34 35 36 Score 2 x 2 3 x 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 1 x Standard No 37 38 39 40 41 42 43 Score x x x x 1 1 x Sherwood Court I52_s19524_Sherwood Court_v221042_140405 Stage 4.doc Version 1.20 Page 20 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 20.1 20.6 20.7 Regulation 13(2) Requirement Timescale for action 14/04/05 2. 24.1 24.6 24.11 28.1 30.1 42.1 13(4)(a) 23(2)(b)& (o) The home manager must ensure that all medicines in the home are handled in accordance with the Medicines Act 1968, Guideline from the Royal Pharmaceutical Society, the requirements of the Misused of Drugs Act 1971. The temperature of the storage area must be below 25 degrees Centigrade. All medicines for external use must be stored separately from those for internal use. (The home manager immediately rectified the situation: all medicines are now stored in the drug cupboard. A drug cupboard for controlled drugs has been ordered.The storage temperature is being monitored and recorded). The premises must be of sound 14/04/05 construction and kept in a good state of repair externally and internally. The external grounds must be kept tidy, safe and accessible to service users. The grounds must be consistently maintained. The premises must be kept clean and Version 1.20 Sherwood Court I52_s19524_Sherwood Court_v221042_140405 Stage 4.doc Page 21 3. 24.1 42.2(ii) 23(4)(c ) (iv)&(v) 4. 31.1 31.2 36.1 18(2) 5. 41.1 17(2)(3) (a)(b) (Schedule 4 (14) 6. 42.4 13(4)(a) hygienic. (The home manager immediately removed the hazards; all rubbish was cleared by 16/04/05; the lounge carpet will be replaced). The home manager must make adequate arrangements for the maintenance of all fire equipment; must review fire precautions and must test all fire equipment at suitable intervals. The home manager must ensure that staff have clearly defined roles and responsibilities to help maintain the home in a consistent way; must ensure that staff receive the support and the supervision they need to carry their jobs. Records required by regulation for the protection of the service users must be mantained, must be up to date; must be accurate. The home manager must ensure that such records (including fire equipment service records) are at all times available for inspection. The home manager must ensure compliance with the Control of Substances Hazardous to Health Regulations (COSSH) 1999. (All COSSH substances were immediately removed to a secured and locked facility. The COSSH cupboard door was repaired on 19/04/05 21/04/05 14/04/05 14/04/05 14/04/05 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 20 Good Practice Recommendations The use of a maximum/minimum thermometer for I52_s19524_Sherwood Court_v221042_140405 Stage 4.doc Version 1.20 Page 22 Sherwood Court 2. 42 recording the room temperture where the drug cupboard is installed to ensure that the temperature is consistently below 25 degrees Centigrade. Daily recording is to be maintained. It is recommended that refresher courses on COSSH and Health and Safety be arranged for all staff to attend. Sherwood Court I52_s19524_Sherwood Court_v221042_140405 Stage 4.doc Version 1.20 Page 23 Commission for Social Care Inspection Mercury House 1 Broadwater Road Welwyn Garden City Herts AL7 3BQ 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. 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