Inspection on 08/05/06 for Sherwood Court

This inspection was carried out on 8th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found no outstanding requirements from the previous inspection report, but made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Sherwood Court 09/07/08

Sherwood Court 01/08/07

Sherwood Court 26/02/07

Sherwood Court 07/10/05

Sherwood Court 14/04/05

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

Bramley Avenue (73)

Paradise Lodge

Grangewood

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 ONX Lead Inspector Mrs Alison Butler Unannounced Inspection 8th May 2006 10:00 Sherwood Court DS0000019524.V294104.R01.S.doc Version 5.1 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 DS0000019524.V294104.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. 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 DS0000019524.V294104.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Sherwood Court Address The Common Hatfield Hertfordshire AL10 ONX 01707 262 405 01707 259 563 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) Caretech Community Service Limited Cara Marie O`Keeffe Care Home 8 Category(ies) of Learning disability (8), Learning disability over registration, with number 65 years of age (8), Physical disability (8), of places Physical disability over 65 years of age (8) Sherwood Court DS0000019524.V294104.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th October 2005 Brief Description of the Service: Sherwood Court is a residential care home for eight service users with learning and physical disabilities. Fees for the services are £1,236 per week. Additional charges are made for newspapers, toiletries etc. 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 corridors and rooms are all wheelchair accessible. The lounge overlooks a small courtyard that has a patio with plants. There is a garden area to the rear, which has a paved area. Sherwood Court DS0000019524.V294104.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two inspectors conducted this inspection and the report has been drawn up following a visit to the home and using information received since the last inspection in October 2005. Discussions were held with the deputy manager, area manager and staff on duty. It is expected that later this year a series of questionnaires will be sent out to people involved in Sherwood Court to ask their views on care provided at the home. An additional visit was conducted on 16th December 2005 this was to check on compliance with three statutory requirement notices that had been served on 17th October 2005. The outcome from this visit was that one of the three had been complied with. The other two were given an extension on the timescales to be followed up at a further visit. A further additional visit was conducted; the reason for this visit was to undertake a specialist pharmacist inspection. (See main report for further details). What the service does well: What has improved since the last inspection? The medication processes have been tightened up especially in regard to the controlled drugs. Staff have updated their training requirements to ensure they are competent to carry out their roles. Sherwood Court DS0000019524.V294104.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Sherwood Court DS0000019524.V294104.R01.S.doc Version 5.1 Page 7 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 Outcomes Statutory Requirements Identified During the Inspection Sherwood Court DS0000019524.V294104.R01.S.doc Version 5.1 Page 8 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 the following standard(s): 2 Quality outcome in this area is good. The judgement has been made using the available evidence, including a visit to the home. Potential residents would have their needs fully assessed prior to admission. EVIDENCE: There have been no recently admitted residents since the last visit. From the files examined showed that they had completed an assessment process prior to admission. A policy and procedure is in place for admissions to the home. Sherwood Court DS0000019524.V294104.R01.S.doc Version 5.1 Page 9 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 the following standard(s): 6, 7 & 9 The quality outcome in this area is adequate. This judgement has been made using the available evidence, including a visit to the home. Residents’ needs are assessed and any goals reflected within their care plans. Support and advice is given to the residents to help them make decisions about all aspects of their lives. Risk assessments are completed although some of these require up dating enabling them to have an independent lifestyle as possible. EVIDENCE: Each resident has a plan and some of these provide very detailed information, one of them should be more person centred. Reviewing of these should be expanded to reflect the care plans and whether the needs are being met. Risk assessments are in place for most activities although some of these require updating. The residents files are extremely bulky and are difficult to handle, a discussion took place with the deputy and it was recommended that some of the old information should be archived and only keep in the relevant and most up to date information available within the files. Sherwood Court DS0000019524.V294104.R01.S.doc Version 5.1 Page 10 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 the following standard(s): 12, 13, 15, 16 & 17 Quality outcome in this area is good. This judgement has been made using the available evidence, including a visit to the home. Staff support residents to participate in activities in the community. Staff communicated with the residents in an appropriate manner, using their preferred mode of communication for the individual. Residents are offered a choice of menu. EVIDENCE: Due to the residents complex needs finding out their views is difficult from observations they appeared happy and staff were observed spending time with the individual residents. Residents each have a programme in place detailing their activities for the week. Sherwood Court DS0000019524.V294104.R01.S.doc Version 5.1 Page 11 They have had difficulties with the transport as the home has lost its driver. A replacement driver should be engaged very shortly. The care staff who are able to drive the minibus have been covering during this time. The weekly menu is on display in the kitchen, staff members take it in turns to prepare, cook and serve the meal. Menus are revised as necessary and with the input of a dietician. Sherwood Court DS0000019524.V294104.R01.S.doc Version 5.1 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 the following standard(s): 18, 19 & 20 Quality outcome in this area is good. The judgement has been made using the available evidence, including a visit to the home. Residents are treated with respect and dignity. They are able to receive personal support in the way they prefer, with the constraints of health and safety of them selves and staff. Health needs are taken care of and are recorded within their plans. Medication has been handled in accordance with policies and procedures. With the exception of a risk assessment and storage temperature. EVIDENCE: Support required by each individual is recorded within their care plans detailing the action required. The staff spoken to are knowledgeable about the needs of the residents and they prefer to be supported. Health information is recorded within the care plans. There is a key worker system in place this provides continuity of care. No residents are able to administer their own medication. Examination of the records showed that they were well kept. All bottles had been dated on opening. The temperature was being recorded although this must be monitored to ensure that it is kept below the manufacturers instructions. A risk Sherwood Court DS0000019524.V294104.R01.S.doc Version 5.1 Page 13 assessment must be put in place for residents whose relatives take responsibility medication on home or day visits. Where medication is carried over from the previous month a bring forward system should be put in place to allow for reconciliation at any point in time. To ensure that staff remember to sign for creams it is suggested that a separate administration record is kept with the creams in the residents rooms. Sherwood Court DS0000019524.V294104.R01.S.doc Version 5.1 Page 14 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 the following standard(s): 22 & 23 Quality outcome in this area is poor. This judgement has been made using the available evidence, including a visit to the home. Residents have been put at risk, as procedures were not followed effectively. EVIDENCE: At the time of this report an investigation is underway. A resident had suffered a fractured ankle and this was reported under the Adult Protection Procedure. From the evidence collected it is believed that procedures had not been followed to fully protect the residents. The outcome of this investigation is not yet known. Due to the complex needs of the residents it is difficult to establish if there views are listened to or acted upon. Although observations during the inspection showed that the staff appear committed to ensuring the residents receive the care required. Sherwood Court DS0000019524.V294104.R01.S.doc Version 5.1 Page 15 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 the following standard(s): 24 & 30 Quality outcome in this area is poor. This judgement has been made using the available evidence, including a visit to the home. A number of areas have been identified that require attention to ensure that the residents are provided with a well-maintained environment. EVIDENCE: A tour of the home found that the bathroom that the missing tiles must be replaced and the shelving, which is rusting, must be replaced. The fan was also not working effectively. A further bathroom was being used for storage of equipment and therefore further storage facility must be sought. Some furniture in residents’ bedrooms needs to be replaced or repaired. Where items in residents’ bedrooms do not belong to them these should be removed. A number of areas were very dusty this is not helped by the fact no cleaner is employed and care staff are expected to try and maintain cleanliness which is very difficult due to the complex needs of the residents and the demand on their time. Sherwood Court DS0000019524.V294104.R01.S.doc Version 5.1 Page 16 The outside garden area is in a very poor state. The small area outside the conservatory could be made pleasant with some small tubs planted with flowers and shrubs etc. The larger area to the rear of the home is overgrown and looks very shabby. There is a small pathway along the edge to allow access to the residents in wheelchairs. It is worth looking at paving over a greater proportion of this, which would create a larger area for the residents to access and make it easier for staff as it would create larger pathways. This must be improved to create a more pleasant and safe environment for the residents. Sherwood Court DS0000019524.V294104.R01.S.doc Version 5.1 Page 17 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 & 36 Quality outcome in this area is adequate. This judgement has been made using the available evidence, including a visit to the home. Staffing levels need to be reviewed to ensure that residents’ needs are met at all times. Appropriate checks are carried out on staff prior to commencing their employment to ensure that residents are supported and protected. Staff receive training relevant to the role and to ensure they meet the residents needs. EVIDENCE: Due to the complex needs of the residents a review of the staffing levels must be carried out, to ensure that residents needs are met at all times. Discussion with members of staff showed that they were expected to take on the role of a cleaner where possible, but they felt this took them away from the meeting the needs of the residents promptly. Staff were observed to be very caring and understanding on how the residents needs are to be met. Sherwood Court DS0000019524.V294104.R01.S.doc Version 5.1 Page 18 A training programme is in place and staff attend as and when necessary to maintain their skills and competency. A check on staff files showed that appropriate checks have been carried out prior to commencing their employment. All new staff are provided with an induction programme to be completed within six months. It is recommended that a pro forma is obtained prior to an staff member from an agency is employed to work in the home, this will ensure as far as possible they have had the required checks carried out and have had appropriate training for the resident group. The deputy manager is going to look at ensuring that staff receive regular supervision, as this has not been happening due to the absence of the manager. Sherwood Court DS0000019524.V294104.R01.S.doc Version 5.1 Page 19 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality outcome in this area is adequate. The judgement has been made using the available evidence, including a visit to the home. The home has not been managed as well as it could have been due to the manager being absent from the home. The Health, Safety and Welfare of the residents and the staff are promoted on most occasions. See other sections for comments. A quality assurance system is being carried out by an external agent to ascertain that Sherwood Court is providing a appropriate service to meet the residents needs at all times. EVIDENCE: The manager has been absent from the home and the deputy manager has been ensuring the residents needs continue to be met. Discussions with the staff on duty felt that morale in the home is improving; there has recently been the departure of three staff. The deputy manager has been doing a good Sherwood Court DS0000019524.V294104.R01.S.doc Version 5.1 Page 20 job in the absence of the manager and is being supported by an operations manager. A risk assessment must be carried out on the use of the loft ladders and it was felt that as they had no handrail this could be a potential hazard to staff as it was being used for storage of continence aids etc. and staff were regularly going up and down with items in their arms. It is recommended that alternative ladders are purchased which have a handrail in place. An external agent is due to carry out a quality audit of the service, which will result in a report being produced and an action plan with areas that need improvement over the coming months. Sherwood Court DS0000019524.V294104.R01.S.doc Version 5.1 Page 21 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. 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 1 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 X 3 X X 2 X Sherwood Court DS0000019524.V294104.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA9YA42 Regulation 13 (3) Requirement All risk assessments must be reviewed to ensure they are up to date and protect the residents at all times. A risk assessment must be completed for relatives who take medication responsibility of medication away from the home. The proprietor must ensure that appropriate staff are employed to protect the residents at all times The proprietor must ensure that the external grounds are brought up to an acceptable standard and they are appropriately maintained and suitable for the residents. Suitable storage facilities must be provided to ensure the home is clutter free at all times. The proprietor must ensure that at all times staff are employed in appropriate numbers to ensure the home is kept clean at all times The proprietor must ensure that risk assessments are completed and reviewed regularly to ensure the safety and welfare of the residents at all times. DS0000019524.V294104.R01.S.doc Timescale for action 30/06/06 2 YA20 13 (2) 30/06/06 3 YA23 18 30/06/06 4 YA24 23(2)(o) 31/07/06 5 6 YA24 YA30YA32 23(2)(l) 18 & 23(2)(d) 31/07/06 31/07/06 7 YA42 13(4) 30/06/06 Sherwood Court Version 5.1 Page 23 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 3 4 5 6 Refer to Standard YA6 YA6 YA20 YA34 YA36 YA37 Good Practice Recommendations All care plans should be person centred. When these are being reviewed they should be more detailed to reflect the care plan and ensure the needs are being met. A review of the files should be conducted and all old information archived to make them less bulky The temperature of the medication storage should be recorded to ensure it is kept as per the manufacturers instructions. A pro-forma should be obtained for all agency staff that work within the home. Staff should receive regular supervision to support them in their jobs. There needs to be a consistent approach, team and leadership in the home as soon as possible to ensure the continuity for the residents. Sherwood Court DS0000019524.V294104.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire 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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