CARE HOMES FOR OLDER PEOPLE
Shotley Park Shotley Bridge Consett County Durham DH8 OTJ Lead Inspector
Tanya Newton Unannounced Inspection 20 July 2005 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. Shotley Park B54 S7501 Shotley Park V226973 200705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Shotley Park Address Shotley Bridge, Consett, County Durham, DH8 OTJ 01207 502052 01207 502052 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) Shotley Park Homes for the Elderly Limited Mrs Vanessa Eccles Care Home 45 Category(ies) of Old age, not falling within any other category registration, with number (45) of places Shotley Park B54 S7501 Shotley Park V226973 200705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: N/A Date of last inspection 28th February 2005 Brief Description of the Service: Shotley Park is a former stately home which was built in the 18th Century. The house stands in a parkland setting of 15 acres of trees and meadows. The home provides lovely views of the surrounding countryside. People living at the home are free to make use of the private grounds all around the home. The home is registerd to accommodate 45 older people. The majority of bedrooms are single occupancy however a few double rooms are also available. The accomodation has been adapted to meet the needs of the people living at the home whilst still retaining the overall character and many of the original features of the house. Despite the size of the building the accomodation presents and feels homely. There are spacious south-facing lounges and dining rooms which are well furnished and equipped with televisions. All bedrooms are well lit, tastefully furnished and decorated and there is space for people to bring any personal effects with them. Each bedroom has thermostatically controlled heating, a vanity unit, access to toilets and specially adapted bathrooms. A number of the rooms have en-suite facilities. The home has a shaft lift to the first floor and a stair lift to bedroom accomodation on the second floor. The home endeavours to provide a lifestyle for each resident that satisfies his or her social, cultural, religious, and recreational interests and needs. There are regular visits from a hairdresser, and a therapist who offers aromatherapy and reflexology. The home has its own transport which is made available to people living there on a regular basis.
Shotley Park B54 S7501 Shotley Park V226973 200705 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was unannounced and carried out by the lead inspector and Michele Hargan a Regulation Manager. The inspector was able to speak to many of the people at the home to ask them about their experiences and views of living at Shotley Park. The majority of staff on duty at the time were also interviewed as part of the inspection. The manager of the home was asked about how she ensures that people living there get the care and attention they need. The relevant policies, procedures and information about people at the home were also looked at. A tour of the home was carried out and both inspection staff had lunch with a group of people living at the home. The inspection staff would like to thank everyone they met on the day for their hospitality, help and assistance with the inspection process. People living and staff working at the home both considered that a very good quality service was being delivered. The inspection process also found that the home is providing a high level of care and support to those using the service. In line with current CSCI policy on Proportionality, the inspection focused upon a number of key standard outcomes for service users. The key standard outcomes not inspected on this occasion will be raised during the next inspection of the home. Issues raised in the last inspection were also examined. What the service does well:
The care at the home is very personalised this was clearly demonstrated by the small but important details about individual peoples needs and wishes being recorded within their care plans. The service is centred around the needs of the people living at the home. People at the home said that staff were very helpful and that “if anything was a trouble the staff didn’t show it”, another person said, “the staff were marvellous”. The manager said she believed that if the staff felt happy in their work then this meant the people receiving the service were also happy. The home hold the “Investors in people award” and the manager considered that this was a good indication of how important she thought high standards to be. The accommodation and environment of the home was very good. The home was clean, free from odours and well maintained. Mealtimes were unhurried, food was freshly prepared, tasty, well presented and obviously promoted as a social occasion. Likes and dislikes of individuals were well catered for. The manager for the home enjoyed being active in delivering training to staff and keeping up to date with research and best practice in delivering services to older people.
Shotley Park B54 S7501 Shotley Park V226973 200705 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection?
Staff training has improved so that approximately 85 of staff has now completed training that meets the minimum standards for those working with older people. Changes within the staff team have bedded in now and these appointed as “senior” members of staff have now become an accepted part of the staff team. Two new members of staff have been recruited and will be going through an induction process. Staff morale remains high. The registered manager is now receiving her own professional appraisal from an independent person, which is good practice. A new chef has been appointed and a number of people living at the home said the fresh home- made soups were very good. Sadly there have been a number of deaths at the home since the last inspection. The manager of the service stated that she believed where possible being able to care for someone until the time of their death to be very important. A number of thank you cards and letters from relatives and friends of people who had been cared for when they were gravely ill, confirmed that sensitive care and support had been experienced by them at such times. All staff have received a copy of the General Social Care Council code of conduct for staff. The manager is going to start further training for staff about adult protection. The homes procedures for informing the managers or another responsible person about any matter that may concern them known as the “Whistleblowing” procedures are going to be revisited by staff at the time of the next staff meeting. Shotley Park B54 S7501 Shotley Park V226973 200705 Stage 4.doc Version 1.40 Page 7 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. Shotley Park B54 S7501 Shotley Park V226973 200705 Stage 4.doc Version 1.40 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 Shotley Park B54 S7501 Shotley Park V226973 200705 Stage 4.doc Version 1.40 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) 1,2,3,4,5. The manager and staff make sure that person/s who are considering living at the home and those significant to them are provided with all necessary information so that they can make an informed choice. The manager and staff of the home make sure that a comprehensive written assessment process is carried out so that they and the individual/s concerned can make a realistic decision about living at the home. Shotley Park B54 S7501 Shotley Park V226973 200705 Stage 4.doc Version 1.40 Page 10 EVIDENCE: A brochure about the home is made available to anyone coming to look around and an introductory visit is always arranged. Prior to somebody being admitted to the home the manager or another senior member of staff carry out a visit to meet the person. The appropriate information is gone though with the individual and significant others. The brochure was written with the assistance and input from people living at the home and it is available in a range of different formats. Each person living at the home has a contract, which contains information about the terms and conditions of residence. Costs for additional services are made clear to people. The assessment process for anyone considering living at the home on a permanent basis starts on “day one” according to the manager. Care plans and assessment information record how the needs of people are to be met. A resident who had quite recently moved into the home said “I like it, I came to have a look around before I moved in…………and the staff are very good”. Shotley Park B54 S7501 Shotley Park V226973 200705 Stage 4.doc Version 1.40 Page 11 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) 6,7,8,9,10. The manager and staff of the home ensure that care plans are carefully compiled so that they contain all of the necessary information. The care plans are “live” documents, which are regularly reviewed with the individual/s concerned. The manager and staff of the home understand the importance of caring for people until the time of their death. The written testimony of families and friends confirm that meaningful and sensitive care had been provided at such times. Shotley Park B54 S7501 Shotley Park V226973 200705 Stage 4.doc Version 1.40 Page 12 EVIDENCE: Care plans included information about health, personal and social care needs. Staff compile the care plans in consultation with people receiving the service or their advocates. Completed care plans are then shared with the individuals concerned. The manager and staff at the home have effective relationships with visiting medical staff and health care was considered to be a high priority. Risk management plans are in place for all those living at the home, individual GP’s are consulted where appropriate so as to fully inform this process. Monthly reviews of individual plans of care are carried out by the manager or senior staff, and appropriate consultation with the person concerned and where necessary their advocates are also a part of this process. Appropriate medication policies and procedures are maintained, people are given an opportunity to administer their own medication and an appropriate risk assessment process would be carried out to support this. In practice the manager stated that medication is usually administered by staff. However if someone were being admitted with a view to returning home, assurance was made that the necessary assistance would be provided so that selfadministration of medication could continue. Particular importance was attached to staff compiling useful information about a person’s previous life history and experience so that the individual experience and identity of the person could be better preserved. Consultation with people confirms that they felt treated with dignity and respect by staff. Information is stored securely and permission is obtained from the person concerned if any information from their care plan is referred too for training purposes. Shotley Park B54 S7501 Shotley Park V226973 200705 Stage 4.doc Version 1.40 Page 13 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) 12,13,14,15. The social, cultural and religious needs of people living in the home are thoughtfully identified and people receive the necessary support so that they exercise their individual lifestyle choices. Contacts with the local community are maintained. Food is appetising, attractively presented and a good choice is available. Shotley Park B54 S7501 Shotley Park V226973 200705 Stage 4.doc Version 1.40 Page 14 EVIDENCE: The manager stated that establishing the recreational activities of people living at the home forms part of the assessment process. A recreational activities co-ordinator is employed for 24 hours a week and this member of staff is responsible for organising and supporting people with activities. The local clergy visits the home on a regular basis and religious holidays are celebrated. Staff respect the faith choices of people at the home and people are free to visit services held in the home or in the local community. Celebrations and decorations at Christmas were positively commented on by both the residents and staff as something that the home does particularly well. A range of gentle exercise classes is provided for those wishing to participate and additional services such as reflexology and massage. People can purchase manicures and pedicures individually. There are a number of regular contacts with the local community, which take place, including visits by and to a local school for various performances. A number of fund raising activities have been hosted by the home, however the manager was careful to point out that additional facilities were provided externally to the home so that visitors had no need to go into the residents home. Transport is available at the home in the form of a people carrier and everyone who is able, is given an opportunity to be taken out. The “handyman” for the home was referred to as the “driver”. Mealtimes were noted to be unhurried, food was freshly prepared, tasty, well presented and obviously promoted as a social occasion. Likes and dislikes of individuals were observed to be well catered for. Shotley Park B54 S7501 Shotley Park V226973 200705 Stage 4.doc Version 1.40 Page 15 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) 16,17,18. Comments, concerns and complaints are listened to and action is taken to address them. The legal rights of people using the service are upheld. The manager promotes the protection of vulnerable adults through training, monitoring the quality of the service and by being a visible presence to people living and working at the home. Shotley Park B54 S7501 Shotley Park V226973 200705 Stage 4.doc Version 1.40 Page 16 EVIDENCE: The guide for service users contains information about how to make a complaint. The manager stated that residents and their families were made aware that she had an “open door policy” so that any concerns could be raised with her. Informal complaints were recorded within the daily log. A copy of the complaints procedure was on display within the home and reference to both the CSCI and the Ombudsman is contained within it. The manager made assurance that to date; any issues had been resolved without having to invoke the full complaints procedure. Residents are able to vote. Personal allowances for individuals are paid in to their own separate bank accounts. If anyone needs assistance with managing his or her financial affairs the services of the local authority can be requested by the manager. Advocates and the Citizens Advice Bureau representatives have also been made available to individual residents. Staff had received training about the protection of vulnerable adults and there were plans in place for additional training to be undertaken in this area. There were no concerns or reports of any incidents of abuse of service users at the home. A good practice recommendation was made by the inspection team about an addition to the homes disciplinary procedures for staff. It is recommended that the procedure make clear to staff their responsibility to report any suspicion or concern in relation to adult protection to a senior member of staff and that failure to do so may be grounds on which to implement the disciplinary procedure. Shotley Park B54 S7501 Shotley Park V226973 200705 Stage 4.doc Version 1.40 Page 17 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) These standards were not assessed during the course of this inspection. EVIDENCE: Shotley Park B54 S7501 Shotley Park V226973 200705 Stage 4.doc Version 1.40 Page 18 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) 27,28,29,30. Staff are sufficient in numbers and skill so that the needs of people using the service are well met. Recruitment practices are safe. Staff receive training to equip them for working with and supporting older people. Shotley Park B54 S7501 Shotley Park V226973 200705 Stage 4.doc Version 1.40 Page 19 EVIDENCE: Staffing levels within the home were found to be more than adequate. One member of staff said that training was good and that “all seniors had completed their NVQ level 3 training”. The manager stated that 85 of staff had completed the level of NVQ training as referred to within the National Minimum Standards for older people. Another member of staff said that she liked working at the home because “residents are treated the way that I would like to be treated”. The availability of training for staff was also reported to be good. Another member of staff described working at the home as “marvellous, strict but fair, service users are the priority and are looked after well”. A resident said, “I could tell someone if I had any problems or if I feel upset”. Another resident who had been at the home for a few months commented that “ I think I am well cared for, I love it, staff knock on your door, speak to you nicely and treat you well”. Recruitment records were checked and found to contain all of the necessary information bar one reference, which could not be easily located. The files could be improved by the use of dividers so that information is better organised. A contents sheet listing all of the information needed as part of the recruitment process for staff should be put at the front of each file and “signed off” by the manager so that the recruitment process is more easily demonstrated and understood. References for staff should also be confirmed by a follow up telephone call, which should then be recorded, on the signing off sheet. Shotley Park B54 S7501 Shotley Park V226973 200705 Stage 4.doc Version 1.40 Page 20 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) These standards were not assessed during the course of this inspection. EVIDENCE: Shotley Park B54 S7501 Shotley Park V226973 200705 Stage 4.doc Version 1.40 Page 21 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 3 3 4 4 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 4 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 4
COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 4 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 4 3 x x x x x x x x Shotley Park B54 S7501 Shotley Park V226973 200705 Stage 4.doc Version 1.40 Page 22 No 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 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 29 Good Practice Recommendations The registered person should ensure that recruitemnt files are sorted and organised by means of file dividers. A signing off sheet listing all elements of the recruitmen t process should be used to demontrate completion of this process. Written references should confirmed by telephone and recorded as such on the aforementioned sheet. Consideration should be given to provide a loop system of communication within the home. The driveway to the home should be repaired to make it safe and accesible to service users, staff and visitors to the home. 2. 3. 22 19 Shotley Park B54 S7501 Shotley Park V226973 200705 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection No.1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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