Inspection on 04/07/06 for Shipley House

This inspection was carried out on 4th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Shipley House 15/07/08

Shipley House 14/02/06

Shipley House 04/10/05

Shipley House 16/01/05

Shipley House 08/09/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Shipley House 10 Station Road Ilminster Somerset TA19 9BD Lead Inspector Lesley Jones Unannounced Inspection 4th July 2006 10:00 Shipley House DS0000016219.V302276.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 Shipley House DS0000016219.V302276.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. Shipley House DS0000016219.V302276.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Shipley House Address 10 Station Road Ilminster Somerset TA19 9BD 01460 55628 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) Mrs Leah Manders Mr Matthew Manders Miss Amanda Jane Barthorpe Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Shipley House DS0000016219.V302276.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th February 2006 Brief Description of the Service: Shipley House is registered to provide support and some personal care for up to four people with moderate independent living skills, who have a learning disability. It is one of two small homes owned by Mr and Mrs Mathew Manders and is situated in the town of Ilminster. Miss Amanda Barthorpe is the registered manager of this home and has responsibility for the day to day care of the residents in both homes supported by Mr Manders the proprietor who oversees work placements, day services, and runs the business. The staff team work across both houses. Staff support residents in this house, although there are regular times when they are left at home without a staff member for brief periods. The main aim of Shipley House is for residents to develop the full extent of their abilities and have full and happy lives. Shipley House DS0000016219.V302276.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector would like to thank the managers, staff and residents for the warm welcome and help throughout the inspection. The main part of this inspection was unannounced with a brief announced visit taking place to check on some recruitment records. The inspection took place over six and a half hours on two days. The time was spent between Shipley House and 2 Speke Court. All Key Standards were inspected on this occasion. The majority of information in this report has been taken from the Shipley House report. Most of the inspection was spent at Shipley House, where the majority of paperwork is kept and policies and practices are the same in both homes. Time was spent with the residents at Speke Court to consult and seek their views on the home and the services they received. The manager of Shipley House Mr Manders and the manager of Speke Court Miss Barthorpe joined the inspection for a short time with staff recruitment files. There was also an opportunity to talk to a member of the staff team. The inspector looked around parts of the buildings and selections of records were read. The provider completed a questionnaire prior to the inspection. This document provides information about residents and staff and evidence that necessary policies and procedures are in place. The manager of Shipley House Mr Manders and the manager of Speke Court Miss Barthorpe joined the inspection for a short time with staff recruitment files. There was also an opportunity to talk to a member of the staff team. The inspector looked around parts of the buildings and selections of records were read. The provider completed a questionnaire prior to the inspection. This document provides information about residents and staff and evidence that necessary policies and procedures are in place. Some feedback cards were left at the home for staff and residents to complete. On previous occasions all feedback has been very positive and expressed great satisfaction with the quality of services at both homes. Shipley House DS0000016219.V302276.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Three recommendations were made during this inspection. The provider was asked to ensure that plans are implemented to seek feedback on the service from residents, relatives and other agencies involved with the home. Shipley House DS0000016219.V302276.R01.S.doc Version 5.2 Page 7 The provider was asked to ensure that the recording of complaints follows formal guidance. A written response should be given to complainants and complaints should be recorded in a separate complaints file. The provider was also asked to ensure that formal interviews with prospective employees are fully recorded. It is also good practice to record informal visits to the home by prospective employees. 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. Shipley House DS0000016219.V302276.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Shipley House DS0000016219.V302276.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, Quality in this outcome area is good. Although there have been no new admissions since the last inspection, previous inspection of the process has demonstrated that the home has good pre-admission arrangements that also provide good opportunities for the service user to decide about moving in. There are good systems in place that ensure the home is able to meet residents’ needs. EVIDENCE: Residents have been living at the home for a number of years. Some talked about how they visited and had trial periods before deciding to stay long-term. The manager completes a detailed assessment that provides information to ensure the home is able to meet residents’ needs safely. From this assessment, plans of care are completed and risks are highlighted, with detailed actions on how to reduce any risks. Residents confirmed the assessments were completed with them. Shipley House DS0000016219.V302276.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9, Quality in this outcome area is good. Resident’s benefit from knowing about the written information that helps to meet their needs effectively and safely. EVIDENCE: Residents are consulted and contribute to their care plans and assessments of risk. The plans have detailed information that highlights care and health needs clearly. Any risks associated with residents’ needs or care is assessed and the action necessary to reduce the risks is clearly explained. Residents attend regular care plans reviews with the providers and the manager. Residents said they are consulted about all aspects of their life and supported to make decisions. It was clear throughout the inspection that residents are included in decisions about the running of the home. The atmosphere is fun, friendly and inclusive. Shipley House DS0000016219.V302276.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17, Quality in this outcome area is good. Service users benefit from suitable educational, leisure and social opportunities. Service users benefit from staff that enables them to use local facilities and resources, providing measured individual support outside as required. Service users enjoy a holiday break away from home each year and have opportunities to access local leisure resources. Service users are assisted to maintain good relations with relatives and friends. Service users are treated with respect, their rights and responsibilities are recognised and care is provided in private. Service users benefit from a well balanced diet. Shipley House DS0000016219.V302276.R01.S.doc Version 5.2 Page 12 EVIDENCE: Residents were keen to talk about the educational and leisure pursuits they attend. These ranged from college courses, swimming, shopping, drama, cinema and many more. The residents use the local pub and are very much part of the local village. Annual holidays are chosen through residents’ meetings between both Shipley House and Speke Court. The holidays are taken together as a group. All residents clearly enjoyed their holidays and spending time with each other. This year, all went on holiday to Dundledoor in Dorset for one week, staying in two caravans. The residents said they are supported to maintain contact with family and friends. Many residents go on holiday with their families and every six weeks all residents from both houses go home for the weekend. This is a flexible arrangement that can be changed. Shipley House DS0000016219.V302276.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20, Quality outcomes in this area are good. Residents are supported in a way they prefer and their health care needs are well met. EVIDENCE: Residents said they felt they were well taken care of and there health care needs were met. The manager demonstrated a good understanding of residents’ health care needs. Care plans provided further evidence that health care needs were assessed, monitored and met. Medication is supplied in a monitored dosage system. The home also keeps over the counter medication that has been agreed with GPs and as part of a Homely Remedy Policy. All staff have received medication training. Shipley House DS0000016219.V302276.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23, Quality outcomes in this area are good. Resident’s benefit from a good complaint’s procedure, however some work needs to be carried out to formalise the complaints procedure. The home manages complaints responsibly and can demonstrate that residents are listened to and complaints made, are taken seriously. EVIDENCE: Residents said they felt they were listened to and if action was necessary it was acted upon. They knew about the complaint’s procedure but said they would talk to the staff, manager or provider in the first instance. Regular house meetings are held with residents where their views are recorded and action is taken when necessary. During this visit we discussed the management of an external complaint about a resident. Records maintained in the individuals care plans demonstrated that appropriate action was taken to address the concerns raised and plans made to avoid any recurrence of the problem. The provider was asked to ensure that the homes complaints policy is extended to include a record kept in a separate complaints file, and a written response for complainants. Shipley House DS0000016219.V302276.R01.S.doc Version 5.2 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 outcomes in this area are good. Residents benefit from a comfortable, clean and hygienic environment. EVIDENCE: Residents were keen to show the inspector round the home and to some bedrooms. The house is bright, spacious, clean and decorated and furnished to a good standard. The bedrooms seen were furnished and decorated to residents’ tastes and preferences. The atmosphere throughout the house is warm and homely. Shipley House DS0000016219.V302276.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 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, Quality outcomes in this area are good. Residents benefit from a competent staff team with recruitment practices that protect residents. The provider must extend records related to recruitment practice to include a record of the formal interview with prospective employees. EVIDENCE: Overall, staff files showed that residents are well protected with the home’s recruitment practices. This includes all the requirements of Schedule 2 of the Regulations. Unusually, there has been some change to the staff team, with the retirement of a long standing member of staff and appointment of her replacement. The provider needs to record the formal interview of prospective employees. It is also good practice to record informal visits by prospective employees to the home. Shipley House DS0000016219.V302276.R01.S.doc Version 5.2 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 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): 37,39,42,43, Quality outcomes in this area are good. Residents benefit from a well run home that includes systems that ensure good quality of care is received. EVIDENCE: The provider of both homes is also the registered manager of Speke Court. The provider has obtained a qualification in management. The manger of Shipley House carries out the day-to-day responsibilities of both homes with the support of the provider when necessary. At this inspection, residents spoke highly of the manager of Shipley House and the provider. They felt the home was well run. The manager has a variety of methods that ensures the quality of care delivered to residents is a high standard. These range from staff training and supervision, residents’ & staff meetings, resident & relatives’ satisfaction surveys, care plan reviews, environmental checks and many more. The Shipley House DS0000016219.V302276.R01.S.doc Version 5.2 Page 18 manager has produced these standards into a document with time scales. This means that all staff are aware of what should be completed and when. At the last inspection, the manager had plans to include residents’ and relatives’ surveys in this document, this has net yet been implemented. It is a recommendation or this inspection, that the provider seeks feedback from residents, relatives and other involved agencies. Miss Barthorpe also has an NVQ 4 in care and the Registered Managers award. Shipley House DS0000016219.V302276.R01.S.doc Version 5.2 Page 19 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 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 2 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x Shipley House DS0000016219.V302276.R01.S.doc Version 5.2 Page 20 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. Standard Regulation Requirement Timescale for action 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 YA23 Good Practice Recommendations The provider was asked to ensure that the homes complaints policy is extended to include a record kept in a separate complaints file, and a written response for complainants The provider was asked to ensure that formal interviews with prospective employees are fully recorded. It is also good practice to record informal visits to the home by prospective employees It is a recommendation of this inspection, that the provider seeks formal feedback through the use of questionnaires from residents, relatives and other involved agencies. 2 YA34 3 YA43 Shipley House DS0000016219.V302276.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Shipley House DS0000016219.V302276.R01.S.doc Version 5.2 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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