Inspection on 18/05/05 for Shiels Court

This inspection was carried out on 18th May 2005.

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 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

Shiels Court 28/08/09

Shiels Court 22/10/07

Shiels Court 03/01/07

Shiels Court 19/12/05

Shiels Court 24/08/05

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Shiels Court Braydeston Avenue Brundall Norwich NR13 5JX Lead Inspector Hilary Shephard Announced 18 May 2005 9.30am th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Shiels Court I55s63180ShielsCourtv220301080405(4).doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Shiels Court Address Braydeston Avenue, Brundall, Norwich Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01603 712029 Mr M Afsar Manager in post. Spplication for registration expected soon Care Home 40 Category(ies) of Dementia (40) registration, with number of places Shiels Court I55s63180ShielsCourtv220301080405(4).doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: One (1) Service User the age of 65 may be accommodated All outstanding inspection requirements must be complied with within six months of the purchase completion date The home adjoining Shiels Court, known as number 2 Braydeston Avenue, must be seperated from Shiels Court within one week of this registration A manager must be put forward for registration within six months The following areas of concern must be addressed immediately upon registration: A minimum of three waking night staff are to be employed at all times, one of whom must be a designated senior, and this must be increased as Service Users needs dictate Two written references and Criminal Records Bureau checks must be obtained on all new staff prior to their commencement The downstairs ladies WC must be altered to protect Service Users dignity and privacy at all times Date of last inspection 6th December 2004 Brief Description of the Service: Shiels Court is a large Victorian house situated in the village of Brundall. The original house has been altered and extended over the years and now provides care and accommodation for up to 40 older people with dementia. The bedroom accommodation for service users is on three floors and consists of 26 single and 7 shared bedrooms (all with ensuite w.c.) The communal space consists mainly of one very large lounge/diner with a partition across, a separate smaller lounge and at the rear of the building another small lounge, which is often used by staff for training purposes, and by visitors as an area to meet service users in private. Shiels Court I55s63180ShielsCourtv220301080405(4).doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was carried out over 9 hours and involved residents staff and visitors. Evidence was obtained from residents, visitors, staff, management, pre-inspection questionnaire, comment cards, care plans and staff files. The home has recently been sold to a new provider who has worked hard with the manager to meet many of the outstanding requirements from previous inspections. What the service does well: What has improved since the last inspection? The décor has improved, with one bedroom being redecorated and refitted with new furniture and many others redecorated. The Proprietor has plans to replace the furniture and redecorate in all bedrooms. Residents and families have been involved with the bedroom décor and have been able to choose the paint colour. Care plans have improved a little, and further work needs to be done. Staff training has improved, and the manager has worked hard to ensure that all staff have received training in adult protection and basic care practice. The home employs some staff whose first language is not English, and the manager has ensured that they are provided with English lessons, which has improved their interaction and communication with the residents. Shiels Court I55s63180ShielsCourtv220301080405(4).doc Version 1.30 Page 6 The manager has improved infection control practices, providing more hand wash facilities, and individual antibacterial sprays for staff to use whilst carrying out care duties. The management structure has improved, and there is a deputy manager who works closely with the manager and care staff, and the communication within the staff team is much better. The manager is proactive and promptly addresses issues that have been identified as causing concern to the residents. The food has improved, and the cook is now directly involved in food ordering and planning of menus and meals. More food is also available to the residents in the evenings. What they could do better: The care plans need to be more focused on providing personalised care and on what each person is able to achieve. Care plans need to be more individualised and should include a more detailed history of the residents’ life to enable staff to have a greater understanding of their emotional and social needs. Care plans also need to have much more detailed guidelines to provide staff with the information they need to enable the residents needs to be met. Assessments of nutrition and risk of falling need to be done so that staff are aware of and can meet these needs. The garden needs further improvement to provide an environment which is safe for people who are confused and disorientated and laid out in a way that reduces anxiety and provides stimulation and occupation. The Proprietor and manager are aware that changes need to be made to the garden area and will be addressing this. Staff need more specific training in dementia care to ensure that the residents receive care specifically tailored to meet their dementia needs. Staff also need updates in moving and handling to ensure that residents are not placed at risk of injury. Pre-employment checks have improved, but the home needs to ensure that all staff have been checked before they commence employment to make sure they are not on the Protection of Vulnerable Adults (POVA) register. Shiels Court I55s63180ShielsCourtv220301080405(4).doc Version 1.30 Page 7 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. Shiels Court I55s63180ShielsCourtv220301080405(4).doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Shiels Court I55s63180ShielsCourtv220301080405(4).doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 All residents have their needs assessed by the home prior to admission and are confident that these will be met by the staff. The home is careful to admit those whose needs they are able to meet. EVIDENCE: The manager visits prospective residents and completes a full assessment of their current needs. This assessment is used to form the basis of their care plan. Two pre-admission assessments were looked at, and both covered all aspects of the residents emotional, social, physical and psychological needs. Further assessments are made on admission to the home, and the information gathered is used to formulate a care plan. Residents and relatives were satisfied that their needs were well cared for. Shiels Court I55s63180ShielsCourtv220301080405(4).doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 and 8 All residents have a plan of care, but not all their needs are assessed or identified after admission, and the guidelines for staff are not clear enough to ensure the correct care is given. EVIDENCE: Care plans are being developed for each resident, and the home has introduced a new care plan computer programme, which has been designed for specific use in Shiels Court. The manager has undertaken much work to implement proper care plans, and the home plans to continue to improve them. Care plans omitted a life history, and were not individualised enough to enable proper individualised and person centred care to be given. The guidelines for staff to follow were too brief and need to be much more specific regarding how staff are to meet the residents needs. Care plans contained a moving and handling assessment but did not include falls risk assessments or adequate nutritional assessments. The care plans contained very good detail regarding Doctor and District Nurse visits. A requirement has been made regarding care plans and assessments. Shiels Court I55s63180ShielsCourtv220301080405(4).doc Version 1.30 Page 11 Shiels Court I55s63180ShielsCourtv220301080405(4).doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 15 Residents receive nutritious and well prepared meals made from fresh ingredients. EVIDENCE: The home has changed the way they buy the food, choosing to buy fresh produce from local suppliers. The meal served on the day of the inspection looked tasty and appealing, and residents said they enjoyed it very much. The cook is involved in preparing menus, and all residents able to make a choice are able to choose their meal. The manager has also improved the amount of food available, increasing the food provided at supper to include sandwiches. Shiels Court I55s63180ShielsCourtv220301080405(4).doc Version 1.30 Page 13 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 Complaints are handled well by the home, and residents benefit from the staff having had adult protection training and a greater understanding about adult abuse. EVIDENCE: The home has received two complaints since the previous inspection. One was regarding care needs, and the other was regarding communication and recording of personal details. Although one complaint had been referred to the Commission, the manager had already put measures in place to resolve the issues raised and this is still ongoing. The other complainant had responded to the managers investigation, indicating they were satisfied that the issues raised had been dealt with and they had no further concerns. Staff have all received training in adult protection and staff spoken with demonstrated a good understanding of adult abuse. Shiels Court I55s63180ShielsCourtv220301080405(4).doc Version 1.30 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26 The environment, décor, cleanliness and hygiene have improved enormously since the previous inspection thus providing residents with a clean and safer environment. The garden needs further improvement to provide a safe and secure facility for those who are confused and disorientated. EVIDENCE: Some of the bedrooms have been refurbished, and one had new furniture. The proprietor plans to refurbish all of the bedrooms on a regular programme. The downstairs ladies toilet has been improved and now provides the residents with privacy. All staff notices and equipment have been removed from resident areas and re-sited in the laundry area. The home has a large garden, which in some places is secure but other areas need to be made safer and more appropriate to meet the needs of confused and disorientated people. The Proprietor and manager have plans to improve the garden and a recommendation has been made. Shiels Court I55s63180ShielsCourtv220301080405(4).doc Version 1.30 Page 15 The manager has introduced new infection control procedures, and staff are encouraged to use special antibacterial hand sprays whilst undertaking care duties to prevent cross-infection. Shiels Court I55s63180ShielsCourtv220301080405(4).doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29 and 30 By obtaining two written references for staff prior to commencement, the home is able to protect the residents better, but residents could still be at risk, as POVA first checks are not being completed. Staff are placing residents at risk of injury by using incorrect handling methods, and lack of specific dementia training prevents service users from receiving good dementia care. EVIDENCE: Staff files were checked, and the home is following their recruitment policies, but is experiencing difficulties obtaining checks in a timely fashion from the Criminal Records Bureau, and are not obtaining POVA first checks whilst they are waiting for the CRB check to be done. Staff are working under supervision until the CRB check is received, but the home could protect residents further by ensuring a POVA fist check is completed before staff commence and a requirement has been made. Staff were seen to be using incorrect methods of moving the residents and the manager advised that their moving and handling training was due to be updated. Staff have received training in basic care practice, also induction and foundation training and are due to commence NVQ training, but have not had any specific dementia care training. A requirement has been made regarding training. Shiels Court I55s63180ShielsCourtv220301080405(4).doc Version 1.30 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 and 38 Residents’ personal finances are managed well, and they are protected by safe working practices. EVIDENCE: The home manages small amounts of money for some of the residents, and all transactions are documented. Fire alarms are tested weekly, staff have received training in fire safety, and the manager plans for staff to undertake first aid training. Shiels Court I55s63180ShielsCourtv220301080405(4).doc Version 1.30 Page 18 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 2 x x x x x x 3 STAFFING Standard No Score 27 x 28 x 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x 3 x x 3 Shiels Court I55s63180ShielsCourtv220301080405(4).doc Version 1.30 Page 19 Are there any outstanding requirements from the last inspection? one requirement is repeated 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 7 Regulation 15 Timescale for action The Registered person must Immediate ensure that all care plans contain and a life history, and provide full ongoing and detailed guidelines covering residents physical, social, emotional and psychological needs. Previous deadline of 6.12.04 not met. The Registered person must 15th July ensure that falls risk 2005 assessments and nutritional screening is carried out for each resident and reviewed as needs dictate. The Registered person must Prior to ensure that POVA first checks commence are obtained whilst waiting for ment of CRB checks and PRIOR to staff new staff commencement and that staff continue to be supervised until the CRB is received The Registered person must 31st August ensure that dementia care 2005 training and moving and handling training is provided for all staff Requirement 2. 8 13 3. 29 19 4. 30 18 Shiels Court I55s63180ShielsCourtv220301080405(4).doc Version 1.30 Page 20 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 19 Good Practice Recommendations The Registered person is recommended to provide a safe and secure garden area to meet the needs of confused and disorientated people. Shiels Court I55s63180ShielsCourtv220301080405(4).doc Version 1.30 Page 21 Commission for Social Care Inspection 3rd Floor, Cavell House St Crispins Road Norwich NR3 1YF 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. Extracts may not be used or reproduced without the express permission of CSCI Shiels Court I55s63180ShielsCourtv220301080405(4).doc Version 1.30 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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