Inspection on 09/07/08 for Sherwood Court

This inspection was carried out on 9th July 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Sherwood Court 01/08/07

Sherwood Court 26/02/07

Sherwood Court 08/05/06

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 28/09/2008.

CARE HOME ADULTS 18-65 Sherwood Court The Common Hatfield Hertfordshire AL10 0NX Lead Inspector Mrs Alison Butler Unannounced Inspection 9th July 2008 09:00 Sherwood Court DS0000019524.V368128.R01.S.doc Version 5.2 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.V368128.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 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.V368128.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sherwood Court Address The Common Hatfield Hertfordshire AL10 0NX 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) www.caretech-uk.com CareTech Community Services Ltd Manager post vacant 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.V368128.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st August 2007 Brief Description of the Service: Sherwood Court is a residential care home for eight service users with learning and physical disabilities. 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. The fees as at 09/07/08 are £1167 per week. Additional charges are made for newspapers, toiletries etc. For up to date fees for the services contact the manager of the home. Information regarding the services can be found in the Statement of Purpose and Service User Guide, these and a copy of the last CSCI inspection report can be requested from the manager. Sherwood Court DS0000019524.V368128.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. We, the Commission for Social Care Inspection, carried out this key unannounced inspection between 09.00 and 14:30 and took just over 5 hours to complete. We looked at documentation, observed what life was like in the home, spoke with people and staff and had a look round the home. Our records show that we sent them an Annual Quality Assurance Assessment and this was returned to us as requested. The document is a self-assessment document that the provider completes which focuses on outcomes for people living in the home and also gives us some numerical information. For the purpose of this report people who live at the home are referred to as “people”, “person” or “residents”. What the service does well: What has improved since the last inspection? Work has been undertaken to improve the environment for the residents by updating the paintwork and by replacing furniture in the dining room and in a resident’s bedroom that was looking tired and was no longer able to be repaired safely. So that people are kept safe the fire door has now been replaced to ensure that it activates safely if the alarm is triggered. Sherwood Court DS0000019524.V368128.R01.S.doc Version 5.2 Page 6 Some work has been carried out on producing the information about the home into easy read format for the residents and any prospective residents that may choose to live at Sherwood Court. 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 DS0000019524.V368128.R01.S.doc Version 5.2 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.V368128.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can be confident that an assessment will be carried out to ensure that their needs can be met. They are provided with information to ensure they are able to make an informed choice of where they can live. EVIDENCE: There have been no further changes in the home since the last inspection, but a full and detailed assessment procedure is in place, should a vacancy arise at the home. Whilst some work has been carried out in producing the information about the home into a pictorial format further work is to continue to reduce the amount of written information, which makes it difficult for those who lack communication skills. Sherwood Court DS0000019524.V368128.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People who live at Sherwood Court can be assured that residents are involved in decision making as fully as their abilities allow, and that they will have a care plan to direct staff although their changing needs are not always reflected which may mean that people do not always receive the support as required. EVIDENCE: We looked at a sample of care plans and found that on the whole they contained detailed information of the action required by staff on how people like their needs to be met. A number of risk assessments are in place but these have not all been written for individuals and are generic. For example when the fire alarm is activated one resident chooses not to vacate the building, the protocol for this should be included in how staff manage this situation. Again it was noted that a resident who uses a wheelchair, had not had information included in the risk assessment about the use of the lap belt to ensure that it is not being used as a form of restraint and guidance on when it should be used Sherwood Court DS0000019524.V368128.R01.S.doc Version 5.2 Page 10 etc. When a risk assessment refers to a resident’s behaviour guidelines should be included to ensure that staff manage these consistently to provide the support to the person. Where additional information has been included on the individual support plans the author should sign and date this to provide a clear audit trail of the reviewing process and take ownership of the information written. The new manager is working on the individual plans to ensure that they contain all the up to date information and empower the residents in all areas of their lives by improving staff skills on active listening and body language. Sherwood Court DS0000019524.V368128.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live at Sherwood Court are supported to take part in and access the community for activities to meet their needs and expectations. EVIDENCE: Staff support the residents to live and take part in various activities in the local community such as swimming, pub, shopping and days out. They have introduced therapeutic and beauty sessions, which have been welcomed by the residents. The residents have the use of a company vehicle and have recruited a driver, which has increased the use of the local community for the residents. The staff would greatly benefit from having the Internet installed to provide information and pictures to residents, showing places of interest to which they could then make choices of places to go. Staff and residents would be able to view this together. Staff would also be able to put together information and Sherwood Court DS0000019524.V368128.R01.S.doc Version 5.2 Page 12 create a folder with pictures, which would aid the communication with those whose skills are limited. Staff were seen to interact well with the residents and appeared knowledgeable of their needs and treated them with respect. Those residents spoken to told us they enjoyed living at Sherwood Court and the staff were nice and helped them to go out. Staff have supported residents to plan their annual holidays for those wishing to go. Days out are planned for those who choose not to have a period away from the home. Menus are planned in consultation with the residents and their likes and dislikes and are changed in line with resident’s choices. They are also able to seek the advice of a dietician if required to ensure they provide a nutritional and varied diet. The staff are looking to purchase a digital camera to be able to take pictures of meals which will further support residents in making choices. Sherwood Court DS0000019524.V368128.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People who live at Sherwood Court have their personal and health care needs met as preferred. Medication procedures have further been updated to prevent errors and ensure people are kept safe. EVIDENCE: Each resident have their own Health Action Plans, these record any health issues and the outcomes of all appointments with health care professionals. Medication is provided by the local pharmacy in a monitored dosage system (a blister system). Two further medication incidents have occurred since the last inspection. This has resulted in residents receiving too much medication although fortunately they received no ill effects from the errors. The manger has brought in the local pharmacist to help in the reviewing of their procedures. Handover checks are made at each handover to check medication that has been administered. Medication taken by each person is recorded, but this has not been dated or signed by the author, which would ensure that the list is current and that staff take ownership for the information. Sherwood Court DS0000019524.V368128.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People who live at Sherwood Court can be assured that their views will be listened to. However, records do not show that staff have received training to ensure that residents are safeguarded from abuse, which may leave residents at potential risk. EVIDENCE: A complaints procedure is in place at Sherwood Court although no complaints have been received since the last inspection. The Hertfordshire County Council Safeguarding Procedure is in place and staff are clear of the whistle blowing policy. The manager is introducing 1 to 1 sessions for each resident to allow residents the opportunity to express their suggestions and concerns. There has been a safeguarding referral since the last inspection and this resulted in staff leaving the home. The AQAA states that staff training includes safeguarding but there was no evidence available to us to confirm when staff had last had this training especially following this recent safeguarding incident. There had also been a reported error in the petty cash system and further work has been carried out in how this is managed and a new procedure is to be introduced. This also includes the management of resident’s monies to ensure a full audit trail is in place, as the account books examined on the day Sherwood Court DS0000019524.V368128.R01.S.doc Version 5.2 Page 15 did not reflect the money held in the tin as staff complete a slip of paper to say the money has been taken but it is not recorded in the book until they return with the change and receipt. This is not good practise as the piece of paper could go missing and then there is no trail as to where the money has gone. This was discussed with the manager and a new procedure was to be introduced to keep a full audit trail. Sherwood Court DS0000019524.V368128.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live at Sherwood Court live in a homely comfortable and safe environment, which meets their needs and preferences. EVIDENCE: The atmosphere of the home was calm and relaxed and residents appeared to be happy with their environment. New dining room and one residents bedroom furniture has been replaced due to it looking very tired and it being unable to be repaired, this has been done in consultation with the residents. Bathrooms have been updated with the aid of a grant and these provide a pleasant and relaxed environment for the residents. More work has been undertaken in the garden to provide a stimulating environment and it looks more appealing, colourful and welcoming in which residents can enjoy when the weather allows. Plans for the coming year were Sherwood Court DS0000019524.V368128.R01.S.doc Version 5.2 Page 17 reported to be to purchase some new garden furniture, as this is now looking tired and worn. Sherwood Court DS0000019524.V368128.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People who live at Sherwood Court are protected through the homes robust recruitment procedures, which ensure people are kept safe. However, training records need to show that staff are adequately trained and competent to support the people in this service. EVIDENCE: The staff team at Sherwood Court has become consistent to provide residents with staff who are able to support and understand their needs. Residents are protected as far as is possible by a series of checks being made on new staff prior to commencing employment at Sherwood Court. Where agency staff are required they use people who are known to the residents and try to provide consistency where possible. Training records should be updated to give a clear picture of what training has been carried out and where there are any gaps in staff knowledge and or updates as required. Sherwood Court DS0000019524.V368128.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People who live at Sherwood Court have their health, safety and welfare protected through a series of checks. EVIDENCE: The manager has recently been appointed and is in the process of applying to be registered with the Commission For Social Care Inspection. The home have been supported by a company peripatetic manager to ensure the residents receive the appropriate care and staff receive the support required to support the residents. As already stated access to the Internet would provide and support the manager in her role, ensuring she is kept up to date with good practice, polices, procedures and regulations whilst at the home. Sherwood Court DS0000019524.V368128.R01.S.doc Version 5.2 Page 20 The manager was due to attend training but came to the home to assist in the inspection and was able to give us information of what areas were in need of improvement over the coming year. Some changes have already been identified especially in areas to ensure that complaints and safeguarding issues are addressed appropriately. However, the changes have yet to be embedded into practice. Regulation 26 reports were available and were detailed and included action points to be managed over the coming months and these included night visit, maintenance and discussion had taken place with residents to gain their views of living in the home. The last available quality assurance report was dated December 2006 this area must be addressed to ensure they are meeting Regulation 24 of the Care Home Regulations 2001 and that the views of those who live at Sherwood Court are sought, with a process for reviewing and improving the care provided. The office door has been replaced and now provides a safe environment if the fire alarm is activated. Sherwood Court DS0000019524.V368128.R01.S.doc Version 5.2 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 2 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 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 X 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 3 X 2 X X 3 x Sherwood Court DS0000019524.V368128.R01.S.doc Version 5.2 Page 22 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 YA23 YA35 Regulation 18(1)(a) & (c)(i) Requirement Staff must receive appropriate training in safeguarding to ensure that residents are protected and safeguarded at all times. Records must be available for inspection. A review of the quality care is in place and is maintained and reviewed at appropriate intervals to ensure the residents are being provided with good quality outcomes. Timescale for action 30/09/08 2 YA39 24 30/09/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard YA9 YA23 Good Practice Recommendations Risk assessments should also include guidelines especially in relation to managing behaviour issues and ensure that residents receive consistent care at all times. A full procedure should be put in place to provide a full audit trail and ensure residents monies are safe and they are protected from abuse at all times. Sherwood Court DS0000019524.V368128.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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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