Inspection on 14/02/07 for Silver Springs

This inspection was carried out on 14th February 2007.

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 Springs 03/01/08

Silver Springs 16/11/05

Silver Springs 09/05/05

Silver Springs 30/12/04

Silver Springs 23/07/04

Silver Springs 24/03/04

Silver Springs 22/08/03

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

CARE HOME ADULTS 18-65 Silver Springs 12 Rosslyn Road Watford Hertfordshire WD18 0JY Lead Inspector Key Unannounced Inspection 14th February 2007 10:00 Silver Springs DS0000019525.V330274.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 Silver Springs DS0000019525.V330274.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. Silver Springs DS0000019525.V330274.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Silver Springs Address 12 Rosslyn Road Watford Hertfordshire WD18 0JY 01923 227 852 01923 227 852 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 Devi Sedani Mr K.P. Sedani Mrs Devi Sedani Care Home 10 Category(ies) of Learning disability (10), Physical disability (3) registration, with number of places Silver Springs DS0000019525.V330274.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. This home is registered for 10 people with a learning disability or physical disability (when associated with a learning disability). Residents with physical disability (when associated with a learning disability) shall not exceed 3 at any one time within a total of 10 residents. 16th November 2005 Date of last inspection Brief Description of the Service: Silver Springs is a residential home in Watford providing residential accommodation for 10 adults with learning disabilities. The home can accommodate 3 people who have physical disabilities in addition to a learning disability. The home is a large house in a residential street in keeping with the property around it. The home is easy walking distance from all the amenities of the town centre and there is a large supermarket is just round the corner. The home is in a multi racial area and this is reflected in the service user and staff groups and gives the home a particular personality and place in the local community. The home itself is large and spacious, has parking at the front and a pleasant enclosed garden at the back, a large conservatory has now been added to the back of the property which enlarges the communal space, and is a good flexible space, which can be two smaller areas or opened up to provide a large party room. The Statement of Purpose, Service User Guide and previous CSCI inspection reports are available at the mangers office at Silver Springs (a copy of the Service Users Guide will be provided to prospective service users by the home) CSCI inspection reports are also available on the CSCI web site. The fee range is £700.00 to £1,200 depending on assessed level of need. Silver Springs DS0000019525.V330274.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took place in the late afternoon and through to the late evening of 14th February 2007. We looked at records, gained feedback from service users and staff, did a tour of some of the areas of the home and made general unobtrusive observations throughout the inspection. We found that the National Minimum Standards had been met. Newer members of the staff team demonstrated their competence and skills. We also met with the proprietors who were at the home on the day of the visit. At the end of this inspection feedback was given to the proprietors and manager that this had been a positive inspection, with no requirements being made. What the service does well: What has improved since the last inspection? What they could do better: Neither requirements nor recommendations were made as a result of this inspection. Silver Springs DS0000019525.V330274.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Silver Springs DS0000019525.V330274.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Silver Springs DS0000019525.V330274.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2: Service Users individual aspirations and needs are assessed prior to admission. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three service users’ care plans were looked at during this inspection and these contained full assessment of all needs and aspirations. The assessment is carried out in conjunction with a multi-agency team and there is ongoing tracking to check progress and changes. Silver Springs DS0000019525.V330274.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9: Service users assessed and changing needs, together with their personal goals are recorded in the care plan. Service users are supported, within a risk management framework, to take risks as part of their progress towards more independent living. Assistance is given where necessary to support service users to make decisions. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users told us about the activities they had recently enjoyed or were looking forward to; these included going for a meal, theatre and other trips and plans for holidays. The services users expressed the fun time they had enjoyed at Christmas. Service users plan their individual holidays and leisure pursuits with their keyworker and they were very clear that they make decisions on what they had planned; this was further evidenced in the care plan progress notes (three care plans were studied during this inspection). Silver Springs DS0000019525.V330274.R01.S.doc Version 5.2 Page 10 On the three files studied, individual risk assessments were in place, and these provide guidance to staff in supporting the service users to take risks as part of an independent lifestyle. Service users meetings are held monthly and recorded; the records were made available for this inspection. Silver Springs DS0000019525.V330274.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 15, 16 and 17: The service users enjoy appropriate activities and leisure pursuits. The service users are part of their local community, and enjoy appropriate personal and family relationships. A healthy diet with choices is provided and enjoyed in a relaxed atmosphere. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service users happily exchanged information with us about the various activities they had recently enjoyed and also those they were planning; the told us about their ‘fun’ Christmas events and about the holidays they were individually planning. The individual care plan progress recorded these activities, which had taken place both in their local community and further afield. A local minister visits the service users frequently. Individual service users, in accordance with their belief, celebrate Christian and Divali festivals and the service user were looking forward to attending the Chinese New Year festival Silver Springs DS0000019525.V330274.R01.S.doc Version 5.2 Page 12 on the 18th February 2007. Service users also use the Punjabi temple, Hare Krishna temple and the local Baptist church. Family members and friends are appropriately involved and there are no restrictions on visits. None of the service users are currently involved in a sexual relationship but there is a policy in place to support such; one service user talked about a person they especially liked and staff were observed to support this expression. The menu looked varied and suitable and service users were observed to enjoy a meal during this inspection visit; one service user was being supported to enjoy their meal at a quieter time and one to one with a member of the care staff team. The home has received advice and support from a dietician to understand and plan for good nutrition. Silver Springs DS0000019525.V330274.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19, 20 and 21: Personal support is provided in accordance with individual preference and according to assessed needs. Physical and emotional health needs are met. Medication is appropriately managed. Plans have been drawn up for the care of the individual in the event of terminal illness and death. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Clear guidance is provided for care staff in the care plans for the meeting of personal needs in the manner preferred by the service user; three care plans were studied as part of this inspection. Progress notes provided evidence that health and emotional needs are met; monitoring records were maintained for individuals to provide a profile for health professionals involved in the care of the individual. Guidance includes clear bullet points. A monthly précis of progress is recorded for each individual and this includes: their well-being and the meeting of personal and social needs. Terminal care and funeral arrangements were in place for individuals. Regular reviews are held and other professionals are involved in monitoring and providing input in addition to care the staff team. Silver Springs DS0000019525.V330274.R01.S.doc Version 5.2 Page 14 In checking the medication system in place at the home, it was noted that the system is well managed and audited. There were no gaps in the Medication Administration Record (MAR) and the medication provider (Pharmacist) provides an inspection service of the systems in place. The current service users are not yet able to retain and administer their own medication. Silver Springs DS0000019525.V330274.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23: Service users can be confident that their views will be listened to and acted on. Service users are safeguarded from abuse, neglect and self-harm. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A policy and procedure is in place for the handling of complaints. There had been no complaints in this inspection year. Abuse awareness training is provided to staff and the Hertfordshire County Council joint agency guidelines for the safeguarding of vulnerable adults are highlighted as a reference in the home. Abuse awareness and updates are provided as part of the training programme; a schedule of training events was seen during this inspection together with a sample of attendance certificates. Silver Springs DS0000019525.V330274.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 and 30: The environment is adequately homely, comfortable and is a safe environment. The home is maintained in a clean and hygienic condition. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During this inspection we toured areas of the home including the lounge, the activities room, the laundry, office, hallways, stairs, two bathrooms and two bedrooms; they were seen to be comfortable and maintained in a clean and hygienic condition. The office had been redecorated and the upstairs toilet had been completely refurbished. A new conservatory is now used as an additional activities/social event resource. One service users room had been completely refurbished and there were plans in place to partly refurbish another service users room. The fire records were checked and fire safety checks recorded appropriately. Three monthly fire drills were recorded. Contracts are in place for the maintenance of the fire safety system with quarterly and annual full service. Silver Springs DS0000019525.V330274.R01.S.doc Version 5.2 Page 17 Portable Appliance Testing (PAT) is carried out annually and Gas and Electrical safety checks carried out by the appropriate agencies with current certificates on file. Silver Springs DS0000019525.V330274.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 34 and 35: A thorough staff induction training programme and ongoing training programme is in place. The homes recruitment policy and procedures are adhered to, so protecting service users. Trained staff meet the service users’ individual and joint needs appropriately. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Certificates for attendance at staff training events were produced at this inspection; staff had attended various training events and all mandatory training updates had been included in the training programme, including abuse awareness and medication training. Two staff members were making good progress with level 2 NVQ and three new recruits are qualified nurses in their country of origin. The manager (who is also one of the proprietors) holds an SRN/RMNH. There is clearly a good skill mix within the team. We met with the staff on duty that provided positive feedback regarding the support they are given by their manager. The progress notes indicate that staff understand the service users needs and were able to record appropriately the developments made. Staff were Silver Springs DS0000019525.V330274.R01.S.doc Version 5.2 Page 19 observed supporting service users in a competent and appropriate manner. Staff were observed to support service users in a very meaningful and professional manner. A very professionally written report on the progress of a service user admitted to hospital had been produced by one of the newly recruited care staff who is a qualified nurse in his county of origin; their use of the English language was impeccable. Silver Springs DS0000019525.V330274.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 38, 39 and 42: The home appears to be well run, the service users views and the views of their advocates pave the way for self-monitoring, review and developments in the home. The ethos, leadership and management approach of the home has developed well. There is clear evidence that the health, safety and welfare of service users is promoted and protected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: From observation, speaking with staff and service users, touring the building and looking at records during this inspection, evidence was gained that the home is being well run. Requirements made in respect of Standard YA20 (regarding medication) during the previous inspection, had been met and systems put in place to maintain the achievement of the standard. Silver Springs DS0000019525.V330274.R01.S.doc Version 5.2 Page 21 Service users had enjoyed plenty of appropriate social events and leisure pursuits with ongoing planning for good social inclusion. The evidence gained during this inspection, demonstrated that the home did have a healthy ethos and that the management and leadership approach was satisfactory. The registered manager does respond to any requirements and recommendations from the CSCI and other agencies in an appropriate and timely manner. The proprietors have quality monitoring systems in place. All staff are provided with mandatory training updates including, fire safety, health and safety, food hygiene, abuse awareness, medication training and first aid as well as additional training in accordance with meeting the needs of service users. Some of the care team have other qualifications appropriate to this field of care and some are professional nurses with qualifications gained in their country of origin. Staff enrolled on the NVQ level 2 programme were making good progress. During this inspection we met with the proprietors (one of which is the manager) and during this meeting they were able to demonstrate how she has sought advice and acted on that advice to benefit the service users and the systems in place for smoother management. The health, safety and welfare of service users and staff are promoted and protected as evidenced under the appropriate sections of this report by the systems in place with records that provide evidence that procedures are carried out appropriately. Silver Springs DS0000019525.V330274.R01.S.doc Version 5.2 Page 22 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 3 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 3 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 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 3 3 X X 3 X Silver Springs DS0000019525.V330274.R01.S.doc Version 5.2 Page 23 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. 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. Refer to Standard Good Practice Recommendations Silver Springs DS0000019525.V330274.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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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