Inspection on 21/03/06 for Silver Howe

This inspection was carried out on 21st March 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Silver Howe 24/09/08

Silver Howe 05/12/07

Silver Howe 10/01/07

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Silver Howe Dalton Drive Sedbergh Road Kendal Cumbria LA9 6AQ Lead Inspector Ray Mowat Announced Inspection 21st March 2006 09:00 X10015.doc Version 1.40 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 Silver Howe DS0000066837.V289251.R01.S.doc Version 5.1 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 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. Silver Howe DS0000066837.V289251.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Silver Howe Address Dalton Drive Sedbergh Road Kendal Cumbria LA9 6AQ 01333 340421 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) Hometrust Care Limited Care Home 30 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (30) of places Silver Howe DS0000066837.V289251.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home must at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. The home is registered for a maximum of 30 service users to include: up to 30 service users in the category OP (Old age, not falling within any other category) up to 3 sercice users in the category DE(E) (Dementia over 65 years of age) 30 June 2005 Date of last inspection Brief Description of the Service: Silver Howe is a large detached Victorian building, set in its own grounds in a quiet residential area, on the outskirts of Kendal, Cumbria. It is accessed by a private road at the end of a cul-de-sac. Public transport is within walking distance and the town centre is approximately a mile away. Silver Howe is registered to provide residential care to thirty older people, including up to three people with dementia. All the bedrooms are single, ten of which have en-suite facilities. The home is on three floors, which are accessed by a passenger lift or one of the two staircases. The top floor is used by staff and provides private living accommodation. There are two lounges on both the first and second floor, both comprising a dining area. The home provides a good range of adapted bathing/shower and toilet facilities. There is parking to the front of the building with wheelchair access to the side door. The grounds and gardens are attractively landscaped and well maintained. To the rear of the home there is ramped access to both the garden and patio areas. Silver Howe DS0000066837.V289251.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place on 21st March 2006. The home was recently sold so this inspection was planned to enable me to meet the new owners and acting manager. I met with most of the residents during the day and spoke to staff as they went about their duties. I also formally interviewed three care staff and met with some relatives who were visiting the home. I looked at records that make sure the home is safe and comfortable that residents are well cared for. What the service does well: What has improved since the last inspection? What they could do better: The new owners have looked at what the home could do better and have identified the following areas for improvement, the first two are also good practice recommendations. The information and records about how to care for residents should be looked at to make sure they are accurate and up to date. The training and development needs of staff must be assessed and suitable training provided for them. Other areas the home is developing are training for new staff, more information about people with specialist needs, monitoring of routine health care and looking at how well the recording systems of the home are working. Silver Howe DS0000066837.V289251.R01.S.doc Version 5.1 Page 6 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. Silver Howe DS0000066837.V289251.R01.S.doc Version 5.1 Page 7 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 Outcomes Statutory Requirements Identified During the Inspection Silver Howe DS0000066837.V289251.R01.S.doc Version 5.1 Page 8 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 the following standard(s): 2, 3 The home has sound systems in place to ensure the home is able to meet the needs of new residents and they are aware of the terms and conditions of their stay. EVIDENCE: Residents have either a social services contract or the homes own contract held on file. The contract of terms and conditions is currently being reviewed for private fee paying residents. Senior staff complete a pre-admission assessment in addition to any social work or specialist assessments. This ensures the home can appropriately meet the needs of residents. This assessment is then used to develop a care plan. Silver Howe DS0000066837.V289251.R01.S.doc Version 5.1 Page 9 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 the following standard(s): 7, 8, 9, 10, 11 On the whole health and personal care needs were recorded and responded to appropriately. EVIDENCE: All the residents have a care plan in place, which contains an informative social history as well as personal details and other personal and healthcare information. The monthly review of these has been inconsistent since the last inspection. Medical appointments and other health interventions were recorded and monitored. I discussed with the new owner and manager the content and style of the care plans as they have a tendency to focus on problems. They explained that they plan to review the existing care plans and recording systems and work with staff to develop a more person centred style of care plan. They have already reviewed the process for staff handovers and are introducing a new handover record sheet to ensure valuable information is shared between staff. This sheet will capture important information relating to each resident including daily care, accidents, other significant events and any additional comments to maintain a good continuity of care. I met with many of the residents during the inspection as well as visiting family members. They had a consistently high opinion of the home with one resident saying, “ The Silver Howe DS0000066837.V289251.R01.S.doc Version 5.1 Page 10 staff are grand, it’s a lovely home”. I observed staff being respectful to residents throughout the inspection but there was a warmth and familiarity that confirmed that relationships between residents and staff were good. A new recording form was also being introduced to ensure the home was aware of both personal and family wishes in relation to how people wanted to deal with serious illness and death. There never seems to be a good time to discuss these issues, but the home plans to complete the forms on admission to the home. The form records both personal and practical information that will enable the home to provide appropriate support at these difficult times. Silver Howe DS0000066837.V289251.R01.S.doc Version 5.1 Page 11 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 the following standard(s): 12, 13, 14, 15 Residents were leading a lifestyle of their choosing were enjoying a good quality of life. EVIDENCE: Based on my discussions with residents and staff the home provides a range of planned activities during the week. These are displayed on a notice board in the lounges. They include sedentary group activities which take place in one of the shared lounges such as dominoes or a music/sing-along session, which a few of residents I talked to particularly enjoyed. Bus trips are arranged, which are also popular and involve visits to places of interest or a pub lunch. Individual hobbies and interests are also encouraged, the home also provides a selection of books in addition to regular visits from the mobile library service. Residents are encouraged and supported by staff to keep in touch with friends, family and organisations outside of the home as well as welcoming visitors to the home. There were frequent visitors to the home throughout the day, some of whom I met with. One resident described how her family visit her each week that she looked forward to and was important to her. Another resident talked to me about keeping in touch with her friends from church. I joined a group of residents for lunch in the upstairs dining room. They told me they “enjoyed the food and there was always plenty”. The meal was freshly prepared and provided a balanced diet. One resident on my table was Silver Howe DS0000066837.V289251.R01.S.doc Version 5.1 Page 12 diabetic whose needs had been catered for. Weight and nutrition were monitored on a monthly basis and referrals or advice sought from specialist services as needs arise. Silver Howe DS0000066837.V289251.R01.S.doc Version 5.1 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 the following standard(s): 16 The home’s complaints policy and procedure ensure concerns and complaints are listened to and acted upon. EVIDENCE: The home has a suitable complaints procedure in line with the National Minimum Standards, which is displayed in the foyer of the home. It is also included in the service user guide and statement of purpose. There has been one recorded complaint since the last inspection this was investigated and resolved with a record held on file. The complaint record also contained some staff records, which should be held separately. Silver Howe DS0000066837.V289251.R01.S.doc Version 5.1 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 the following standard(s): 19, 25 26 The home is decorated and maintained to a good standard and provides a safe and comfortable environment. EVIDENCE: Not all aspects of these standards were assessed on this occasion as they were met at the last inspection. The communal areas of the home I inspected were well maintained and found to be clean and hygienic throughout. The home provides a safe and comfortable living environment, which residents and their relatives appreciated and valued. The layout of the home provides adequate communal space and creates a homely atmosphere. Silver Howe DS0000066837.V289251.R01.S.doc Version 5.1 Page 15 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 30 The numbers of staff on duty were adequate however some staff training needs updating to guide and support their practice. EVIDENCE: There have been no new staff since the home changed ownership, however some staff that were recruited recently had not received any formal induction training. The acting manager was aware of this shortfall and was putting plans in place to remedy the situation. This will involve a supervision/appraisal with each member of staff to assess their training and development needs. Once these have been completed the home will produce a staff training and development plan for the coming year. Also the home was introducing a new induction training programme for all new staff. Based on my observations and discussions with staff they were knowledgeable about their role and responsibilities and the individual needs of residents. During the inspection I observed staff carrying out manual handling procedures, which were not good practice. I discussed this with the acting manager, who is a manual handling trainer who has planned training for all staff in May 06. Silver Howe DS0000066837.V289251.R01.S.doc Version 5.1 Page 16 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 34, 35, 37, 38 Despite the change of ownership the home has continued to operate efficiently and effectively. EVIDENCE: The new owners and acting manager have worked hard to ensure the change of ownership and manager will have a minimal impact on the lives of residents. It was evident from my discussions with residents, their families and representatives and staff that a continuity of care had been achieved. People were aware of a forthcoming meeting/social gathering when the new owners and management staff will introduce themselves and discuss any areas of concern. At the point of the inspection the acting manager said he had spoken with about 75 of residents relatives. Based on my discussions and observations the new management team recognise the importance of clear communication and developing good relationships with residents and their families and valuing the role and contribution of the care staff. Resident and staff meetings as well as one to Silver Howe DS0000066837.V289251.R01.S.doc Version 5.1 Page 17 one consultation will be an ongoing feature, to enable people to raise concerns and contribute to the running of the home. It was evident regulation 37 notifications had not been sent in as required for the previous four months when the home was under the previous ownership. However since the change of ownership notifications had been received as required. A priority has been the need to maintain the safety and welfare of residents during the transition period. An audit was completed to identify priorities for action, which has resulted in a new fire policy being developed and fire systems being checked and the management team familiarising themselves with all aspects of the health and safety routines and systems in place. The home has continued to operate efficiently and effectively therefore safeguarding and responding to the best interest of residents and staff. Silver Howe DS0000066837.V289251.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X X X X X 3 3 STAFFING Standard No Score 27 3 28 X 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 3 3 X 3 3 Silver Howe DS0000066837.V289251.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? No 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 2 Refer to Standard OP7 OP30 Good Practice Recommendations It is recommended content of care plans are reviewed and monitored in line with the National Minimum Standards. It is recommended the home collate a training and development programme for the coming year for all staff. Silver Howe DS0000066837.V289251.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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 Silver Howe DS0000066837.V289251.R01.S.doc Version 5.1 Page 21 - 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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