Inspection on 21/04/05 for Shipley Lodge

This inspection was carried out on 21st April 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 17 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Shipley Lodge 23/12/09

Shipley Lodge 22/05/07

Shipley Lodge 26/06/06

Shipley Lodge 04/10/05

Shipley Lodge 02/12/04

Shipley Lodge 10/06/04

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

CARE HOME ADULTS 18-65 Shipley Lodge 94 Derby Road Heanor Derbyshire DE5 7QL Lead Inspector Bridgette Hill Unannounced 21st April 2005 09:30 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 Lodge C52 C02 S39072 Shipley Lodge V221798 190405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Shipley Lodge Address 94 Derby Road Heanor Derbyshire DE5 7QL 01773 535212 01773 535212 shipley.lodge@rethink.org Rethink 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) Debbie Jayne Fenwick Care Home with nursing 16 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (16) of places Shipley Lodge C52 C02 S39072 Shipley Lodge V221798 190405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: Age range of residents - 18 to 65 years With written agreement of the NCSC, residents over the age of 65 who meet the registration category, may be accommodated. Where residents over the age of 65 are residing in the home, consideration is given to the Care Homes for Older People National Minimum Standards The Conditions of Registration to be reviewed annually Date of last inspection 2 December 2004 Brief Description of the Service: Shipley Lodge is purpose built care home. It is situated in the residential area of Heanor close to local shops, public houses and bus routes. The home provides nursing care for up to sixteen people, eight males and eight females, aged 18 to 65 years, who have experience enduring mental health problems. Residents have opportunities to take part in daily living and social activities, and have a more independent lifestyle. The home provides male and female dedicated bathing facilities. All facilities are on the ground floor. There are two lounges, two smoking areas and and one dining room. Residents have their own kitchen and laundry facilities. All bedrooms are single rooms with en suite facilities. The home has a large private garden. Shipley Lodge C52 C02 S39072 Shipley Lodge V221798 190405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was an unannounced one which took place over 6 hours. During the inspection 4 staff members and 6 residents were spoken with. The Inspector ate lunch with the residents. Various records including care planning records were examined the findings are recorded in the body of this report. What the service does well: What has improved since the last inspection? What they could do better: Whilst the quality of available care plans was good expansion is required to include how assessed needs are to be met in relation to mental health needs and social needs The environment is beginning to show signs of wear and a renewal programme is required to ensure prompt actions are taken to repair and replace fixtures and fittings promptly. Improvements were required in the standard of house keeping particularly in bedrooms. This is being affected by existing vacancies for domestic staff. Please contact the provider for advice of actions taken in response to this Shipley Lodge C52 C02 S39072 Shipley Lodge V221798 190405 Stage 4.doc Version 1.20 Page 6 inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Shipley Lodge C52 C02 S39072 Shipley Lodge V221798 190405 Stage 4.doc Version 1.20 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 Standards Statutory Requirements Identified During the Inspection Shipley Lodge C52 C02 S39072 Shipley Lodge V221798 190405 Stage 4.doc Version 1.20 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 standard(s) 1,2,3,4, The admission procedure was a robust one with multi agency assessment and active participation from the resident. These procedures ensured that the residents needs would be met. The system in place for facilitating trial periods was commendable as it was extremely flexible and individually tailored to the residents assessed needs. EVIDENCE: Information was made freely available to residents and visitors. The Statement of Purpose and Service Users Guide was available in a folder in the reception area. Inspection reports were openly available to residents and visitors. Residents had been given individual copies of the Service Users Guide in their rooms. One resident was spoken to regarding the admission procedure this confirmed a gradual introduction to the home. Sometimes introductions to the home occurred over a period of many months. Records indicated full multi agency assessments were completed prior to admission. The resident completed part of the pre admission assessment form. Residents spoken to were positive about the home and the service provided to them. Staff demonstrated a good knowledge of the residents and positive interactions were observed. Shipley Lodge C52 C02 S39072 Shipley Lodge V221798 190405 Stage 4.doc Version 1.20 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 standard(s) 6,8,10 The content of the care plans that were available were excellent but medically orientated. There is potential for needs to remain unmet, as care plans were not in place for all assessed needs. Residents were not being involved in the care planning process as much as was possible. EVIDENCE: The care records of three residents indicated that detailed care plans were in place for some assessed needs, mainly healthcare needs. The care plans did not contain plans for all assessed needs for example mental health and social needs. This is an outstanding requirement from previous inspections. Residents spoken with varied as to the extent they said they were involved in the care planning process. Some records and conversations with residents confirmed active involvement. Other residents said they would like to be more involved. Discussions with staff revealed a good knowledge of the residents and their care needs. Shipley Lodge C52 C02 S39072 Shipley Lodge V221798 190405 Stage 4.doc Version 1.20 Page 10 It was evident from discussions with residents that residents needs were being met but there were not always documented fully for example residents had access to a wide range of social and leisure activities but care plans did not detail the work being done and the progress being made was recorded. A key worker system was in place and all residents spoken to knew who was their allocated key worker. Staff were observed to lock the office where records were held when it was not in use. Shipley Lodge C52 C02 S39072 Shipley Lodge V221798 190405 Stage 4.doc Version 1.20 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 standard(s) 12,13,14,16,17 There were ample opportunities given to residents to develop social skills and interests both inside and outside of the home. This was one of the strengths of the home. EVIDENCE: Residents spoken with said they had opportunities to follow their own interests. Residents were observed to go out into the local community to use the various facilities available such as shops and libraries. Some residents spoken to attended community groups and projects. A programme of activities was available encouraging residents to be culturally aware this was an ongoing project of which the residents spoke very positively. Photographs of events that had taken place were available. An extension of this project has been the sponsoring of a school in Africa with fundraising events being held to raise monies initially for the Tsunami disaster but has extended to the school. Shipley Lodge C52 C02 S39072 Shipley Lodge V221798 190405 Stage 4.doc Version 1.20 Page 12 Residents said they were currently being consulted regarding a choice of holiday destination and had enjoyed holidays the previous year. Some residents were able to spend time out of the home with family and friends. A new menu had been introduced giving residents a wide choice of foods. Through observing the lunchtime meal it was apparent that residents had made personal choices. Residents said they were happy with the foods served. Opportunities were also available for residents to make drinks, snacks or meals for themselves in the kitchen areas. One staff member as observed to help a resident to open mail. Staff were seen to knock on doors before entering bedrooms. Some residents said they did housekeeping tasks. Some residents said staff undertook cleaning duties. It was apparent from the discussions that residents were given a choice of whether to participate in housekeeping tasks. Shipley Lodge C52 C02 S39072 Shipley Lodge V221798 190405 Stage 4.doc Version 1.20 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 standard(s) 18,19,20 Systems were in place to ensure residents were offered appropriate healthcare services. Residents right to refuse healthcare interventions was respected and recorded. The decanting of medications into poorly labelled bottles is a dangerous practice that could affect the well being of service users. EVIDENCE: Records were available to indicate healthcare needs were considered and appointments offered. Some residents had declined these, where this was the case this was recorded. Wherever possible community facilities were used for example blood tests were done at the community hospital. During the inspection a Psychiatrist was undertaking routines visits to residents in the home. Some residents were on a graduated planned programme to achieve selfmediation. Some medications had been decanted by staff into poorly labelled bottles. Some staff who carried medications to administer outside of the home in the event of an emergency had not received accredited medications training. Shipley Lodge C52 C02 S39072 Shipley Lodge V221798 190405 Stage 4.doc Version 1.20 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 standard(s) 22,23 Staff had adequate knowledge of adult protection procedures to ensure allegations of abuse would be handled appropriately but required updating on the protection of vulnerable adults list. Systems for dealing with complaints in the home were in place. The Manager had responded in a positive way to a complaint and action was being taken to address requirements this had not been completed as the timescale had not yet passed. EVIDENCE: One complaint regarding cleanliness of bedrooms has been received by the Commission for Social Care Inspection since the inspection, this was investigated on a visit by the Inspector on 5th April 2005 and was found to be upheld. Action had been partly taken to address the complaint but the timescale for compliance had not passed at the time of this visit, see the section on environment for details of findings. No complaints have been received at the home since the last inspection. Staff spoken to had knowledge of the protection of vulnerable adults and whistle blowing procedures in place but were not fully aware of the advent of the protection of vulnerable adults list and the referral mechanisms for this. This has been identified at previous visits. Shipley Lodge C52 C02 S39072 Shipley Lodge V221798 190405 Stage 4.doc Version 1.20 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 standard(s) 24,25,26,27,28,29,30 Bedrooms were well personalised and personal privacy was respected. The cleanliness in bedrooms was not adequate. The garden was well maintained and a pleasant area for residents to enjoy. The communal areas and facilities offered in the home adequately met the needs of residents and promoted independence. EVIDENCE: The home has been open for 3 years and many carpets and furnishings have not worn well and require replacement as they were badly stained. Some linoleum type floor coverings were lifting at seams. Redecoration of the home appears to be undertaken regularly. Since the last inspection there had been changes in the way the communal space was being used. One large lounge was now used as a dining room. A dining room had been made into a small lounge and one dining room had been utilised as a gym. Discussions with residents revealed a mixed reaction to the gym but most welcomed a dining room where everyone ate together. The following environmental issues require attention; Shipley Lodge C52 C02 S39072 Shipley Lodge V221798 190405 Stage 4.doc Version 1.20 Page 16 • • • • • • Carpets in corridors were badly stained in places. A carpet in a bedroom was badly stained and required replacement. Dust on skirting boards and cobwebs were found in some bedrooms. The flooring in the kitchen had lifted at a seam and required resealing. The sofa’s in one lounge were showing signs of wear. The base of one drawer in a residents room was broken and unusable A complaint regarding cleanliness in bedrooms was investigated on 5th April 2005. It was evident at this visit that ongoing work to raise standards of cleanliness in bedrooms was still required. Not all residents said they had access to the lockable facility that was available in bedrooms but said they did wish to use this. Where residents were assessed as needing any special adaptations or equipment these were observed to be in place. Kitchen areas including laundry facilities were available for residents to use independently, some residents spoken to did use these. Particularly for drinks which they were observed to make for themselves. Shipley Lodge C52 C02 S39072 Shipley Lodge V221798 190405 Stage 4.doc Version 1.20 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33,36 The skill mix and numbers of staff on duty was well maintained and adequate to meet the needs of residents. There was not adequate supervision and support in place for those staff working in the home on a regular bank basis. EVIDENCE: Vacancies for qualified nurses, care staff and domestic staff existed at the time of the inspection. Adverts for these had been placed. Staffing levels were being maintained through the use of agency staff and the homes own bank staff. It was evident from discussion with these staff that the same staff were used wherever possible and these staff knew the homes procedures and residents well. The vacancy for domestic staff was impacting on the standards of cleanliness in the home. Records to assess the previous requirement relating to recruitment practices were not available. Staff who worked at the home on a regular agency/bank basis said there were no formal supervision or support arrangements in place for them. Previous requirement - not able to check this at this visit as records not available Shipley Lodge C52 C02 S39072 Shipley Lodge V221798 190405 Stage 4.doc Version 1.20 Page 18 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39,42,43 Systems were in place to ensure health and safety issues were addressed adequately. There were no structured/regular quality assurance systems in place that involved empowering residents to express their views or gain feedback from visiting professionals, or visitors to the home. EVIDENCE: Discussions with staff and residents revealed that there were no regular formal systems in place to consult with residents regarding their views of the service. No consultations were evident with visitors or healthcare professionals. One survey had recently completed with the results being held in residents file. There were no published surveys available. Health and safety needs were addressed through staff training. Fire records and maintenance of equipment records such as gas, lift and electrical wiring were all up to date. Shipley Lodge C52 C02 S39072 Shipley Lodge V221798 190405 Stage 4.doc Version 1.20 Page 19 The Manager undertook and documented regular health and safety audits of the home. The public liability certificate on display had expired. Records for the purpose of assessing financial liability were not requested. Relevant codes of practice were observed to be available in the staff room. Records were held securely and residents spoken to knew that they had a right to access these and this information was given to residents in the service users guide. 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. Where there is no score against a standard it has not been looked at during this inspection. 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 4 3 4 x Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 Shipley Lodge Score 2 x Standard No 24 25 26 27 28 29 Score 2 3 2 3 3 3 Version 1.20 Page 20 C52 C02 S39072 Shipley Lodge V221798 190405 Stage 4.doc 8 9 10 LIFESTYLES 2 x 3 Score 30 STAFFING 2 Standard No 11 12 13 14 15 16 17 x 3 3 3 x 3 3 Standard No 31 32 33 34 35 36 Score x 3 x x x 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x x 2 x Standard No 37 38 39 40 41 42 43 Score x x 2 x x 3 2 Shipley Lodge C52 C02 S39072 Shipley Lodge V221798 190405 Stage 4.doc Version 1.20 Page 21 Yes 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 YA6 Regulation 15(1) Requirement Care plans must record and detail how social/leisure needs are to be met Timescale for action Previous timescale 30.12.05 new timesale 30th June 2005 30th July 2005 2. YA6 15(1) 3. YA20 4. YA20 5. YA23 13 (2) 17 (1) (a) Schedule 3 13 (2) 17 (1) (a) Schedule 3 13(6)18(1 )(c) Where residents have the capacity to become involved in the care planning process they must be given the choice to do so. Records must be had to demonstrate this has been considered and offered. Medications must be stored in original bottles as labelled and dispensed by the pharmacy All staff with the responsibility for administering medications must receive acredited medication training Staff must receive training on the protection of vulnerable adults list and a policy must be in place for a referral procedure for this A replacement programme must be inplace to ensure furnishings 30th July 2005 30th August 2005 Previous timescale 30.12.04 New Timescale 30th June 2005 30th June 2005 Page 22 6. YA24 23(2)(b) Shipley Lodge C52 C02 S39072 Shipley Lodge V221798 190405 Stage 4.doc Version 1.20 7. 8. YA26 YA26 16(2)(c) 16(2)(c) 9. YA26 23(2)(d) and flooring are promptly replaced when they become worn. Details contained in the body of this report Broken furniture in residents bedrooms must be replaced Residents must be given access to keys and lockable facilities where they wish this and it is assessed as appropriate Bedrooms areas must be kept clean Date of timescale not met at the time of the inspection Staff must be employed in adequate numbers to ensure standards of cleanliness are maintained. All required checks as described in Schedule 2 of the care homes regulations must be completed before prospective employees are allowed to commence employment Previous requirement - not able to check this at this visit as records not available Copies of application forms for staff must be available in the home. Previous requirement - not able to check this at this visit as records not available Records to demonstrate recruitment processes meet required standards must be available in the home Previous requirement - not able to check this at this visit as records not available Disclosure information on Criminal Records Bureau (CRB) checks must be handled in accordance with the Criminal Records Bureau code of conduct Previous requirement - not able 30th July 2005 30th June 2005 Date given following complaints investigatio n 30th april 2005 30th May 2005 Previous timescale September 2003 To be checked at next visit 10. YA32 18(1)(a) 23(2)(d) 19 Schedule 2 11. YA34 12. YA34 19 Schedule 2 13. YA34 19 Schedule 2 Previous timescale September 2003 To be checked at next visit Previous timescale September 2003 To be checked at next visit Previous timescale November 2003 To be checked at next visit Page 23 14. YA34 19 Schedule 2 Shipley Lodge C52 C02 S39072 Shipley Lodge V221798 190405 Stage 4.doc Version 1.20 15. YA36 18(2) 16. YA39 17. YA43 25(e) to check this at this visit as records not available Records must be in place to demonstrate supervision and support is offered to all staff working in the home on a regular basis Quality assurance systems must be put in place to regularly ascertain the views of residents, visitiors and staff A valid public liability insurance certificate must be displayed 30th June 2005 visiting healthcare professiona ls 30th May 2005 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 YA5 YA34 Good Practice Recommendations The service users ‘licence agreement’ should be modified to make the language more user friendly and understandable for the resident group. The home should have a copy of the code of conduct guidance from the CRB regarding the handling of disclosure informationThe home should have its own policy regarding the handling of disclosure information which adheres to the CRB code of conduct document A plan should be put in place to ensure the registered manager has achieved an NVQ level 4 or equivalent by 2005. 3. YA37 Shipley Lodge C52 C02 S39072 Shipley Lodge V221798 190405 Stage 4.doc Version 1.20 Page 24 Commission for Social Care Inspection South Point Cardinal Square Nottingham Road Derby. DE1 3QT 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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