Inspection on 14/06/07 for Sherwood Court

This inspection was carried out on 14th June 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

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Sherwood Court Sherwood Way Fulwood Preston Lancashire PR2 9GA Lead Inspector Vivienne Morris Unannounced Inspection 14th June 2007 09:30 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 Court DS0000069268.V337869.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 Court DS0000069268.V337869.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sherwood Court Address Sherwood Way Fulwood Preston Lancashire PR2 9GA 01772 715508 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) Barchester Healthcare Homes Ltd Mrs Hilary Jane Scott Care Home 69 Category(ies) of Dementia (31), Old age, not falling within any registration, with number other category (36), Physical disability (2) of places Sherwood Court DS0000069268.V337869.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may accommodate up to a maximum of 69 service users to include Up to 36 service users in the category of OP (Old age, not falling within any other category) Up to 31 service users in the category of DE (Dementia) Up to 2 service users in the category of PD (Physical Disabilitity) The service should employ a suitably qualified and experienced manager who is registered with the CSCI. 12th July 2006 2. Date of last inspection Brief Description of the Service: Sherwood Court Nursing Home was a purpose built two-story building, providing accommodation for older people requiring either nursing or personal care, although there were two places available for younger adults with physical disabilities. There were sixty-five single and two double bedrooms available and the majority of these had en-suite facilities. There were two lifts to each floor, which afforded people access throughout the home. Sherwood Court Nursing Home was located in a semi-rural, residential area of Fulwood, Preston. It was surrounded by well-maintained landscaped gardens, which were accessible to residents by means of ramps. A range of garden furniture was available for the comfort of the people living at the home. Sherwood Court was situated close to shops and community facilities and was on a main bus route. Visitors were made welcome at any time and there were several communal lounges and quiet sitting areas where people living at the home could entertain their visitors or they could take them to their own private accommodation if they preferred. The fees at the time of the site visit ranged from £600.00 to £750.00 per week. Additional charges were being incurred for hairdressing, chiropody, bingo, newspapers and escort duties. Sherwood Court DS0000069268.V337869.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced site visit to this service was conducted over one day in June 2007, which formed part of the key inspection process. During the course of the site visit, discussions took place with a number of people living at the home, as well as some relatives and staff members. Relevant records and documents were examined and a tour of the premises took place, when a random selection of private accommodation was viewed and all communal areas were seen. Comment cards were received from nineteen people involved with the service and their feedback is reflected throughout this report. The information provided by the home on the pre-inspection questionnaire has also been taken into consideration when writing this report. The inspector ‘tracked’ the care of three people living at the home during the site visit, not to the exclusion of other residents. The total key inspection process focused on the outcomes for people living at Sherwood Court and involved gathering information about the service from a wide range of sources over a period of time. The Commission for Social Care Inspection had not received any complaints about this service since the last inspection. What the service does well: People were provided with enough information about the home, so that they could make a decision about moving in. In general, comments made by residents and relatives confirmed this. Each persons needs were thoroughly assessed before admission, to ensure that the staff team could provide the care required. Comments received prior to and during the site visit confirmed that a good level of healthcare was provided for the people living at the home and that the privacy and dignity of people was always respected. Comment cards were received from six relatives of people living at the home, which indicated that they were always kept up to date about the care of their relative. One relative stated, “The staff ring me immediately when anything occurs, which I need to know. I am grateful for this”, and another said, “good nursing care is provided”. The management of medications was good, ensuring that people living at the home were safeguarded from medication errors or drug misuse. The home continued to provide a wide range of activities, both inside and outside the home. The majority of comment cards received from relatives Sherwood Court DS0000069268.V337869.R01.S.doc Version 5.2 Page 6 indicated that the differing needs of people were, in general met. One relative stated, “I have noted the excellence in meeting different needs of people, such as religious services”, and another said, ‘my relative is always included, despite her first language not being English”. People were made welcome to the home. This was observed at the time of the site visit. One relative wrote on the comment card, “In the months during which my relative has been resident, I have always been struck by the good moral of staff. There is always a cheery welcome for visitors and staff are happy to discuss residents’ with their closest relative”, and another stated, “I am content that my relative is happy and very well looked after. We are very satisfied. Sherwood Court is a happy ship. The home put on a lovely party for my relatives birthday, which we all really enjoyed – what a kindness”. Complaints were handled well and people felt comfortable to approach the manager of the home, should they have any concerns. Those living at Sherwood Court were adequately protected by the policies, procedures and practices of the home. The home provided a comfortable and homely environment, which was well maintained. Residents’ bedrooms were personalised, nicely decorated and suitably furnished and comments received were favourable in respect of the environment. The numbers and skill mix of staff was sufficient to meet the needs of people living at the home and the management team and staff working at the home showed a strong commitment to staff training. The home was being managed in the best interests of the people living there and a wide range of different monitoring systems closely evaluated the quality of service provided. Systems were in place so that residents’ financial interests and personal belongings were adequately safeguarded and the health, safety and welfare of people living at the home and of those working at the home were sufficiently protected. What has improved since the last inspection? The care planning process had improved since the last inspection, which was thorough, ensuring that the needs of people were consistently met and a wide range of risk assessments had been conducted, so that those living at the home were adequately protected. Sherwood Court DS0000069268.V337869.R01.S.doc Version 5.2 Page 7 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 Court DS0000069268.V337869.R01.S.doc Version 5.2 Page 8 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 Court DS0000069268.V337869.R01.S.doc Version 5.2 Page 9 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. Sherwood Court does not provide intermediate care. Therefore standard 6 is not applicable to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The preadmission process was thorough so that the staff team were sure that individual needs could be met and so that the independence of people could be maximised. EVIDENCE: The care of three people living at the home was ‘tracked’ during the course of the site visit to this service. Care records showed that sufficient information had been collected, from a range of sources, about the needs of people before they moved into Sherwood Court, so that the home was confident that individual assessed needs could be adequately met by the staff team. Sherwood Court DS0000069268.V337869.R01.S.doc Version 5.2 Page 10 Twelve residents had sent comment cards to the Commission before the site visit to the home. A number of these people indicated that their relatives had dealt with their admission to Sherwood Court. However, four residents said that they had been given enough information about the home before they moved in, to help them to make a decision about living there and one said that they had not received sufficient information before they were admitted. Six comment cards were received from relatives of people living at the home and all six said that sufficient information was always provided. One relative stated, “The administrator made financial dealings very simple to understand and was very willing to chat to ease my mind that things would be OK”, another commented, “The home was very helpful when a change of room was requested” and a third said, “The staff reassured my relative when I was on holiday, which made her relaxed. She is looking forward to going back for respite care and it will be the home of our choice should she need full time care”. Sherwood Court DS0000069268.V337869.R01.S.doc Version 5.2 Page 11 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 excellent. This judgement has been made using available evidence including a visit to this service. The health and personal care needs of people living at the home were being consistently met and their privacy and dignity was always respected. EVIDENCE: The care of three people was ‘tracked’ during the course of the site visit, including one person with a pressure wound, as the pre- inspection questionnaire showed that four residents living at the home had pressure sores. The care records were very well organised, providing a clear ‘tracking’ process and the plans of care examined were found to be extremely well written documents, providing staff with clear, detailed guidance about how the assessed needs of people were to be best met. The care plans showed that attention to detail was very important, so that person centred care was clearly promoted. Evidence was available to show that the plans of care were reviewed and up dated on a regular basis so that any changes in care needs were clearly recorded and so that staff were kept up to date with the current needs of individuals living at the home. Residents or their relatives were in the Sherwood Court DS0000069268.V337869.R01.S.doc Version 5.2 Page 12 process of reviewing the plans of care with staff, so that they were able to have some input in the care being delivered. Therefore, the recommendation outstanding from the previous inspection had been addressed to a satisfactory standard. Twelve comment cards were received from people living at the home, which indicated that, in general they received the care and support, which they required. One relative stated, “ The care and attention my relative receives is second to none”, and another said, “There have been very few occasions when we have needed to remind staff about care required”. The pre inspection questionnaire also showed that a variety of external professionals continued to visit the home so that the health care needs of people living there were being consistently met. This was supported by the care records examined. One comment card was received from an external professional, who indicated that the health care needs of people were usually met by this service. This individual made some minor suggestions for improvement, which were discussed with the manager at the time of the site visit. Comment cards received from people living at the home, indicated that they received the medical support, which they required, showing that health care needs were being met. A variety of well-written risk assessments were in place, so that any hazards were identified and strategies had been implemented in order to minimise or eliminate any risks to people living at the home, so that they were kept safe. Some of these documents were extremely detailed, which is commendable. The management of medications was good, showing that people living at the home were safeguarded against any medication errors or drug mishandling. The pre-inspection questionnaire, completed by the manager of the home before the site visit to the service showed that there had not been any changes to the policies and procedures in relation to the six values of care, including privacy and dignity. The plans of care referred regularly to the protection of people’s privacy and dignity, particularly when providing intimate care. Staff were seen treating people living at the home equally, with respect and in a courteous manner. The privacy of people was respected by the provision of bedroom door locks and privacy screens, where appropriate. One relative stated on the comment card, “The residents are treated equally and my relative is afforded the privacy he needs. He is permitted freedom in his daily activities”. Residents spoken to confirmed that their privacy and dignity was respected at all times. One said, “The staff are a lovely bunch. They are all very good with me” and a relative stated on the comment card, “My relative loved her time at this care home and has indeed been back for another respite stay. As I was waved off quite happily it brought peace of mind. The home also offers the whole package – nursing, caring and making the client feel at home – indeed the home is their home and that is a priority”. Sherwood Court DS0000069268.V337869.R01.S.doc Version 5.2 Page 13 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. Social, cultural and recreational activities did not meet all residents’ expectations. Those living in the home received a healthy, varied diet according to their preferences. EVIDENCE: The home employed a person to be responsible for the organisation and provision of activities and those spoken to were, in general, satisfied with the level of leisure activities available. The pre-inspection questionnaire showed that a variety of activities were provided, both within the home and in the wider community, so that people were able to receive some form of stimulation and entertainment, if they wished to participate. People were also encouraged to join in local community life, so that links with outside activities were maintained. Ministers of different denominations held services at the home at regular intervals, so that the religious needs of people were being met. The activities programme was displayed in everyone’s bedroom, informing people of various events and activities, which were planned, so that they could choose which ones were most suitable for them. Relatives were also welcome Sherwood Court DS0000069268.V337869.R01.S.doc Version 5.2 Page 14 to join in any activities provided, so that they had the opportunity to be involved in what was going on in the home. One visitor spoken to said that he went to the home twice a week to help with dominoes despite his relative no longer being at Sherwood Court and that he has kept this up for several years, as he enjoys the company. Participation records were retained for each person living at the home, which showed that 1:1 activities were provided for the more dependent people, so that everyone had the same opportunity to receive some form of interaction in order to prevent boredom and to increase stimulation and interest. People spoken to on the ground floor felt that there were sufficient activities and outings provided to meet their needs. However, it was felt that although some activities were provided for the people living on the first floor they were somewhat restricted in getting out, despite there being an enclosed garden area available, as they needed various levels of supervision. The manager of the home confirmed that the people living on the first floor were able to join in with the activities on the ground floor, should they so wish so that they had the same opportunity as those living on this unit. The plans of care showed that people’s choices had been taken into consideration and they included information about the leisure interests and religious needs of residents so that staff were able to provide activities in accordance with people’s preferences. A policy was in place at the home, showing that consideration was given to the cultural, religious and ethnic needs of people living at the home, including the preferred routines of daily living. People spoken to confirmed that the routines of daily living were reasonably flexible, including being offered a choices of meals and being able to get up and go to bed when they wished. Freedom of movement around the home was evident, with people being able to spend their time in the areas of their choice. Policies at the home included an explanation of the six principals of care, including rights and choices, showing that those living at the home were able to make decisions and informed choices about their life. A visiting policy was in place at the home and information relating to visiting was also included in the statement of purpose and service user guide to ensure that all interested parties were aware of the visiting arrangements of the home. Relatives were seen to be visiting service users in private and visitors spoken to felt that they were welcome to the home at any time and that a friendly environment was provided for both residents and visitors. The inspector noted that personal possessions adorned individual rooms, where appropriate to create a homely environment and audits of service users’ belongings had been conducted on admission to protect the safety of individual’s personal possessions. Sherwood Court DS0000069268.V337869.R01.S.doc Version 5.2 Page 15 People living at the home were able to manage their own finances, if they so wished and if they were capable to do so, showing that they were able to have some control over their lives. Two people living at the home were using an advocate to help them in making decisions. Leaflets were freely available in the home informing people of the choice to access advocacy services, should they wish to do so. The majority of residents who had completed comment cards indicated that staff listened to them and acted on what they said, so that they had some input into their preferred lifestyle. The majority also said that, in general, there were suitable activities provided to meet their individual expectations. One relative commented, “The staff are always pleasant, cheery and helpful”. Six comment cards were received from relatives, one stated, “I am most impressed that after my relatives first period of respite, she was invited back to attend various activities to stay in touch”, and another said, “My relative is encouraged to take part in all activities and interacts well with staff, despite the fact that she only speaks limited English”. One relative suggested that, “it would be good if the TV lounge provided entertainment more suited to the age group. Some TV broadcasts can be depressing. Some old ‘musicals or comedy films on DVD would, I feel, be more engaging”. Other comments taken from relatives cards, included, “The residents are left to their own devices for relatively long periods of time without supervision. More checks should be carried out”, and “The residents upstairs have few places to go. There is no access to the conservatory or the garden. Part of the garden has been made secure, but residents are never taken to sit out there. Hardly anyone gets pushed around the park or through the wood”. The inspector examined the four weekly menus and found that a well-balanced diet was offered to ensure that those living at the home received a nutritious dietary intake. The menu of the day was clearly displayed, so that people were aware of the choices they had been given for lunch. The pre-inspection questionnaire showed that residents were offered a choice of menu and that special diets were provided as required. Those living at the home confirmed this and people were seen being offered alternatives to the menu, as requested. The chef was able to discuss special diets required by people and the kitchen was well organised, with a plentiful supply of food, which was appropriately stored. The food served appeared appetizing in order to aid nutrition and maintain appetite. The inspector noted that specialised utensils were provided to aid in independent eating, but that people were also supported with their meals in a dignified manner as needed. Nutritional risk assessments had been conducted for those requiring their dietary intake to be monitored and fluid balance charts were in place, where Sherwood Court DS0000069268.V337869.R01.S.doc Version 5.2 Page 16 required, so that the home was confident that people were receiving an adequate fluid and dietary intake in order to maintain nutrition. Some people living at the home said that they enjoyed their meals, but others said that the quality of meals varied. Comments included, “The food is excellent”, “The food is very good as is the basic level of care” and “The mealtimes are very well organised and given high profile”. The dining rooms were found to be relaxed areas for people to eat in, with well-presented tables and unhurried atmospheres, so that those dining were comfortable and enjoyed having their meals in pleasant surroundings. It was pleasing to see staff on the dementia care unit having lunch with the people living there, during which time general conversation was taking place between residents and staff, who were interested in what the residents had to say. The residents appeared to be enjoying this part of the day and they looked very happy. Sherwood Court DS0000069268.V337869.R01.S.doc Version 5.2 Page 17 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. Complaints were managed well and concerns were responded to appropriately. The practices within the home adequately safeguarded the people living there. EVIDENCE: The pre-inspection questionnaire showed that there had not been any changes to the complaints procedure since the last inspection. This was included in the service users’ guide, which was clearly displayed in the reception area of the home and in individual bedrooms, informing people of how to make a complaint, should they wish to do so. It was confirmed through comments received from residents and relatives prior to and during the site visit that they would know what to do if they wanted to make a complaint. One person living at the home said, “The manager Hilary is very approachable and I could go to her with any concerns at any time”. One relative said, “The complaints procedure was explained in detail, and a leaflet was given to me”, and another said, “ The home manager is extremely approachable and I would have no hesitation in speaking to her about a concern if necessary”. Records were maintained in the home in respect of any concerns or complaints raised and the action taken. The home should consider developing it’s written information including the complaints procedure in formats, which are accessible to residents currently accommodated and their relatives whose first language is not English. Sherwood Court DS0000069268.V337869.R01.S.doc Version 5.2 Page 18 The pre inspection questionnaire showed that there have not been any changes to the policies and procedures of the home, in relation to safeguarding adults, since the last inspection. Staff were informed during their induction training of all good practice issues and what they should do if they witnessed any practice that they considered to be unacceptable. Safeguarding vulnerable adults was part of the mandatory training for staff, to ensure that those working at the home were fully aware of their responsibilities in relation to reporting concerns about the well being of people living at the home. This training was updated so that any change in guidance was passed on to staff. Staff spoken to were aware of what they should do if they were worried about any possible incidents of abusive situations. Sherwood Court DS0000069268.V337869.R01.S.doc Version 5.2 Page 19 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 design and layout of the home provides a comfortable and safe environment for the people living there. EVIDENCE: The location and layout of the home is suitable for its stated purpose, providing several communal areas for people to sit and chat or join in activities. There were accessible toilets for residents, which were clearly marked and a number of hoists, assisted toilets and baths were available to meet the needs of people living at the home. The home was tastefully decorated and furnished, so that people living there had pleasant areas to spend their time. Comments received during the site visit confirmed that people living at the home liked the environment in which they lived. One person said, “The surroundings are very pleasant and well maintained”. Sherwood Court DS0000069268.V337869.R01.S.doc Version 5.2 Page 20 People’s bedrooms were seen to be personalised with their own belongings, which created a homely atmosphere and made people living at Sherwood Court feel comfortable. Regular audits were carried out in respect of the environment, which identified any health and safety issues, in order to protect those living at the home. The kitchen area had been completely refitted since the last inspection and several areas of the home had been recarpeted, which enhanced the environment. During the site visit the home was clean, tidy and pleasant smelling. Comment cards received from people using the service indicated that on the whole the home was fresh and clean, providing a comfortable environment for those living there. The laundry department was well organised and fit for purpose, with sufficient equipment to meet the needs of people living at the home. One person spoken to said that sometimes people living at the home are not always dressed in their own clothes. However, staff were observed putting laundered clothing into residents’ bedrooms. One resident said that there were not always fresh linen towels and facecloths provided each day. The manager of the home needs to look into these points raised and to resolve any issues identified. Policies and procedures were in place in relation to the control of infection and clinical waste was being disposed of appropriately to reduce the possibility of cross infection. Sherwood Court DS0000069268.V337869.R01.S.doc Version 5.2 Page 21 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. The home has good recruitment procedures in place, but these need to be consistently followed for every new employee. Staff are provided with training opportunities in order to fulfil their potential and ensure they have the knowledge and skills to meet the needs of the residents. EVIDENCE: At the time of the inspection there were 59 people living at Sherwood Court. The duty rota clearly showed which staff were on duty at any time of the day or night and staffing levels were found to be sufficient to meet the needs of the people living at the home. Qualified nurses were on duty at all times who managed the care staff and ensured good practice. One person was receiving continuous 1:1 care and it was evident that additional staff were identified for this purpose on a daily basis to ensure that assessed needs were being consistently met. The files of three people working at the home were examined in order to look at employment procedures. Appropriate checks had been conducted for each member of staff, showing that the people living at the home were, in general, safeguarded by the recruitment practices. However, there was only one reference on the file of one of these members of staff, which did not demonstrate that the home’s recruitment procedures were consistently being followed in day-to-day practice. Sherwood Court DS0000069268.V337869.R01.S.doc Version 5.2 Page 22 The pre-inspection questionnaire showed that a wide range of training courses were available for staff and records showed that all new staff were expected to complete a structured induction programme in line with the Skills for Care induction standards. Within this time all mandatory training was completed to ensure that staff were competent to do the work expected of them. Two of the homes senior staff took responsibility for staff training, having completed trainer’s courses for fire safety and moving and handling so that those working at the home were kept up to date with current training needs. The home also had it’s own National Vocational Qualification assessors so that a percentage of care staff achieved a recognised qualification in care. At the time of the inspection the ratio of care staff with this qualification was 62 , which exceeds the current requirement. Staff training was recognised as essential by the company and any training needs were identified at the time of appraisal, so that personal development was on going and so that staff were appropriately trained to look after the people in their care. Comment cards were received from six relatives, which indicated that, in general staff were appropriately experienced and had the right skills. One of these relatives stated, “There is a first class team to care for my relative”, and another said, “New members of staff are sometimes thrown in at the deep end when they would benefit from more on the job training”. Sherwood Court DS0000069268.V337869.R01.S.doc Version 5.2 Page 23 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. People lived in a home which was well managed and where the quality of service provided was closely monitored. Residents’ financial interests were safe guarded and the health, welfare and safety of staff and people living at the home was adequately protected. EVIDENCE: The manager of Sherwood Court Nursing Home is a Registered General Nurse, who has several years’ management experience in residential care. She has completed the Registered Manager’s Award and continues to up date her skills and knowledge whilst managing the home in order to enhance her personal development. Staff confirmed that there are clear lines of accountability within the home and regular management meetings were held with senior staff to ensure a consistent approach is adopted by the home. One visitor spoken to Sherwood Court DS0000069268.V337869.R01.S.doc Version 5.2 Page 24 said, “I feel that the home is always striving to improve. They always listen to my experience of the home and are interested in the residents”. Residents, staff and visitors spoken to felt that the home was well run and that the manager was very approachable. . Information provided on the pre-inspection questionnaire, completed by the manager stated that all safety equipment was regularly serviced and this was confirmed by random checks of service certificates held within the home, so that the healthy and safety of people involved with the service was adequately protected. There was a good system in place, which assisted the manager to closely monitor the quality of service provided. People involved with the service were encouraged to give feedback about their experiences, in the form of satisfaction surveys, so that the management team could rectify any issues raised. A wide range of audits were regularly conducted to ensure that the home was run in the best interests of the people living there. A representative from the company visited the home regularly and every month prepared a report about the quality of service, which included obtaining feedback from those involved with the home. These reports were available on site and were also forwarded to the Commission for Social Care Inspection, demonstrating that regular audits were in place. A variety of meetings were conducted at regular intervals so that people were able to discuss any relevant matters and so that information could be shared between all interested parties. Minutes of meetings were retained and clearly displayed in appropriate places so that people involved could refer to them as they wished. Some people were involved in ‘the friends of Sherwood’ group, which got together every month in order to discuss plans for the future and records showed that an annual development plan had been produced, which included projected budget management. The home had achieved an external quality award and the service users’ guide tells people about systems in place for monitoring and reviewing the quality of service provided. One relative stated on the comment card, “Improvements could be made by the home building on its existing strengths, by not being too set in routines and regimes. It is always good to be open to new and fresh ideas”. The people living at Sherwood Court were encouraged to deal with their own finances or were asked to arrange an external appointee, either a relative or solicitor. Therefore, the home did not retain any money on behalf of the people living there. However, a petty cash float was available, should residents need any money, which the resident’s appointee would then reimburse. All bedrooms had a lockable facility for the storage of money and valuables and Sherwood Court DS0000069268.V337869.R01.S.doc Version 5.2 Page 25 audits of resident’s belongings had been maintained in order to protect personal possessions. Sherwood Court DS0000069268.V337869.R01.S.doc Version 5.2 Page 26 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 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 4 29 2 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 Court DS0000069268.V337869.R01.S.doc Version 5.2 Page 27 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 OP29 Regulation 19(4)(b)(i) Schedule 2 Requirement The registered person must make sure that two written references are obtained on behalf of all new employees prior to employment. Timescale for action 31/07/07 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 Refer to Standard OP12 Good Practice Recommendations Consideration should be given to providing those living on the dementia care unit with more opportunities to access outdoor facilities so that they remain in touch with the outside world. The home should consider developing it’s written information including the complaints procedure in formats, which are accessible to residents and relatives whose first language isn’t English. The registered manager should review the laundry procedures to identify any possible issues and then implement strategies to resolve them if necessary. 2 OP16 3 OP26 Sherwood Court DS0000069268.V337869.R01.S.doc Version 5.2 Page 28 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. 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