Inspection on 19/09/07 for Silverdale House Care Home

This inspection was carried out on 19th September 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Silverdale House Care Home 09/09/08

Silverdale House Care Home 24/01/07

Silverdale House Care Home 12/04/06

Silverdale House Care Home 17/01/06

Silverdale House Care Home 01/06/05

Silverdale House Care Home 30/11/04

Silverdale House Care Home 27/07/04

Silverdale House Care Home 26/01/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Silverdale House Care Home 3 Nottingham Road Hucknall Nottingham NG15 7QN Lead Inspector Joanna Carrington Unannounced Inspection 19th September 2007 09:30 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 Silverdale House Care Home DS0000008790.V345952.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 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. Silverdale House Care Home DS0000008790.V345952.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Silverdale House Care Home Address 3 Nottingham Road Hucknall Nottingham NG15 7QN 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) 0115 9640400 0115 9634880 Rodenvine Limited Jamil Akhter Mrs Mary Linda Roys Care Home 36 Category(ies) of Dementia - over 65 years of age (5), Old age, registration, with number not falling within any other category (36) of places Silverdale House Care Home DS0000008790.V345952.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 1 named person may be in the category PD. Date of last inspection 24th January 2007 Brief Description of the Service: Silverdale Care Home is registered to provide care and accommodation for up to thirty-six older people. Five of these places are also registered to allow the home to admit older people diagnosed with dementia. The home is situated on a main road close to Hucknall town centre. There are twenty-four single bedrooms and four double-sized bedrooms. The accommodation is on the ground and first floors with two lifts provided to give full access to the upper floor. There is a choice of sitting rooms and a spacious dining room. There are contained gardens to the rear, providing further seating areas. Residents that smoke have a designated smoking room. The manager that had only commenced just commenced her post at the last inspection has now been registered with the Commission for Social Care Inspection. Reports on their own quality monitoring and inspection reports are available to residents and other stakeholders on request. The registered manager intends to make this information available in the information corner that has been set up in the home. The weekly fees range from £298 to £370 per week. This depends on the level of assessed need and also whether you move to the home privately or are funded by Social Services. Silverdale House Care Home DS0000008790.V345952.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit, as part of the home’s key inspection took place on 19th September 2007. Inspections focus on outcomes for people that use the service. In order to do this the main method of inspection used at the site visit was ‘case tracking’ which meant three residents were selected and their support was tracked through discussion with them and with staff, checking their care records and observing practice. Altogether five residents, one relative and four staff members were spoken with. The manager chose to attend the inspection on her day off and was available during the inspection for discussion and feedback. A sample of staff records were also looked at to make sure staff members are checked before commencing employment and are trained to meet residents’ needs. Information about a home that is collected before the site visit is also used as evidence to make judgements. This information could include notifications, information from other professionals and users of the service or their relatives, and also from any surveys that are sent out. Three relative surveys, three resident surveys, and three professional surveys were returned before the site visit took place. Services are now required to fill in a document called an AQAA (Annual Quality Assurance Assessment) in which the registered manager identifies from their own quality monitoring what the service does well at and what they need to improve on. The AQAA was also returned before the site visit and was used to plan the site visit and used to support judgements made in this report. What the service does well: The service does well at promoting the quality of life of residents and meeting their social and recreational needs. A quote from a resident: “There are plenty of entertainments etc outings, sing-a-longs, games music films etc…”meals are usually well though out, well served, a good variety with thought given to different requirements”. Residents are supported to make choices and have control of their lives. Residents go to bed and get up when they want to and can spend their time how they want. Families and friends are always welcome to visit. Residents’ healthcare needs are managed very well. Healthcare professionals are called on when necessary and relatives are always informed if their relative-in-care is not very well or has had an accident. Staffing levels were improving at the last inspection and have continued to evolve around the needs of residents. A resident commented: Silverdale House Care Home DS0000008790.V345952.R01.S.doc Version 5.2 Page 6 “If I need help all I’ve got to do is ask somebody and they are there.” What has improved since the last inspection? What they could do better: There is one outstanding requirement from the last key inspection. Residents that have ‘as required’ medicines must have a care plan stating their consent and when it is appropriate for this medicine to be offered. When it is a medication for relieving anxiety this guidance will ensure residents are not being inappropriately restrained with medication. Care plans need to be more ‘person-centred’ which means they will include more specific information about how individuals want their support. Further work to care plans will also make sure that the content reflects the current needs and support given to residents. Please contact the provider for advice of actions taken in response to this Silverdale House Care Home DS0000008790.V345952.R01.S.doc Version 5.2 Page 7 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. Silverdale House Care Home DS0000008790.V345952.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Silverdale House Care Home DS0000008790.V345952.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 3 (the home does not provide intermediate care) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Significant improvements have been made to admission arrangements, which means residents are assured that the service provided will meet their needs and that their legal rights are protected. EVIDENCE: All three residents case tracked, including a resident that has been admitted to the home since the last inspection, have on their care file a pre-admission assessment carried out by the manager or deputy manager of the home and a copy of the placing authority’s community care assessment, when applicable. All three case tracked residents have a copy of a signed contract with the home. A relative spoken with confirmed they have got a contract. Silverdale House Care Home DS0000008790.V345952.R01.S.doc Version 5.2 Page 10 There is a service user guide, which is kept up to date. A copy of this is held in the information corner all residents have their own copy. This guide provides all the necessary information about the service provided in the home. Silverdale House Care Home DS0000008790.V345952.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The health and personal care needs of residents are well met and improvements to medicine management mean it is now effective in promoting the safety of residents. There is still lack of information for residents that have as required medication for behaviour, which does not protect them from being inappropriately restrained. EVIDENCE: All residents spoken with made very positive comments about the care they receive. Staff were described as “being lovely” and one resident said, “If I need help all I’ve got to do is ask somebody and they are there.” Another resident said they feel safe in the fact that staff come round and check her at night. A resident states in their survey “the medical service is first class. The doctor usually comes within several hours and tablets etc are soon here.” Residents confirmed that staff always respect their privacy and dignity. Staff Silverdale House Care Home DS0000008790.V345952.R01.S.doc Version 5.2 Page 12 were observed talking with residents and supporting them in a respectful manner. There is evidence in care plans and daily records that outside healthcare professionals such as continence nurses, occupational therapists and psychiatrists are called on when necessary. Care planning documentation is satisfactory in that it covers various needs and there are risk assessment tools accompanying plans for nutrition, pressure sore prevention and mobility / falls. Care plans are kept up to date and reviewed but the information in care plans is not always specific enough to individuals’ needs and wishes. For example, a case tracked resident’s care plan for bathing states that “[the resident] is bathed / showered once weekly and washed everyday with supervision.” The language used suggests that the resident has very little choice in this and there is no mention of the resident’s preferences regarding bathing and what the resident can do independently. Staff members spoken with discussed the severe anxiety that one resident suffers with and how diazepam is given to this resident at these times. Although there is a care plan for psychological wellbeing, which has been reviewed every month it does not refer to the anxiety described by staff and the measures in place to support the resident with this anxiety. There is no care plan in place for the administration of the medicine, including evidence of consent and the stage when administering this medicine becomes appropriate. There are conflicting records in the care plan and on daily records as to when this medicine has been given. For all four medicines audited all four remaining quantities tally with what has been signed as given. For all boxed medicines a daily count is undertaken and recorded on the medication administration record (MAR), which helps in monitoring quantities in the home. The manager and deputy manager are also doing daily audits. When a tablet has not been given the reason why is clearly stated on the MAR and the notes section overleaf is also being used correctly. Creams and ointments are being stored securely and administered as prescribed. Silverdale House Care Home DS0000008790.V345952.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Meeting residents’ recreational needs and maintaining contact with family and friends is managed well in accordance with residents’ wishes. There are good arrangements in place for providing wholesome appealing meals. EVIDENCE: All residents spoken with said that their family and friends are always made to feel welcome and they can have visitors whenever they want. Residents spoken with also confirmed that they still feel in control of their lives and can choose how they wish to spend their time and when they wish to get up, go to bed and what meals they would like. Residents were observed enjoying their mealtime and being given two options, with the choice of second helpings. Menu plans have recently been updated through consultation with residents. The manager and the cook meet with residents regularly to ask them what meals they like. Records show that a variety of healthy meals and fresh vegetables are offered. A relative Silverdale House Care Home DS0000008790.V345952.R01.S.doc Version 5.2 Page 14 commented that her relative-in-care has put much needed weight on since moving to the home. A resident comments in their survey that “there are plenty of entertainments etc outings, sing-a-longs, games music films etc…”meals are usually well though out, well served, a good variety with thought given to different requirements”. A resident spoken with reported that they had recently been out shopping and for coffee with a staff member, which she thoroughly enjoyed. There is an activity programme displayed in the hallway, which includes over the week quizzes, movement to music, bingo afternoon, old films, games and crafts. Residents and staff have recently spent time together creating a scrapbook full of pictures of the royal family and classic movie stars. Staff members were observed in the lounge spending time with residents talking with them and watching a classic film. Silverdale House Care Home DS0000008790.V345952.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Significant improvements to the handling of concerns, complaints and allegations mean these are taken seriously and residents are assured their welfare and protection is at the heart of action taken. EVIDENCE: Following the last key inspection a statutory requirement notice was served in respect of complaints management. This was due to non-compliance with recording complaints and in taking action. There is now a complaints file, which contains records of complaints and of action taken, with more sensitive information held securely. No more complaints have been received since the last inspection. Feedback from residents and relatives, either in the surveys or from those spoken with, confirms that people feel comfortable taking their concerns and complaints to the manager and they feel assured that these issues will be effectively dealt with. All staff members spoken with reported that they have had or are due to attend training on adult abuse. All staff members spoken with demonstrated they understand their duty to report all allegations of abuse and to whistleblow. Since the last key inspection there has been one safeguarding adults’ referral made to Social Services following an allegation. This was notified to the Silverdale House Care Home DS0000008790.V345952.R01.S.doc Version 5.2 Page 16 Commission at the time and records seen show that the manager has acted on this quickly and correctly in accordance with safeguarding adults procedures. There are still no outcomes in respect of this allegation and investigation because the manager is still waiting to hear from Social Services and the police. Silverdale House Care Home DS0000008790.V345952.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 26 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Improvements to cleanliness and general maintenance mean the home is now safe, hygienic and comfortable for residents. EVIDENCE: When walking around the home it was clean and hygienic throughout. All residents spoken with confirmed that the home is always clean and fresh. A resident has written in the survey, “many of [her] friends have remarked on it.” Since the last key inspection additional housekeepers have been employed and regular toilet checks have been introduced. The staff team have had practical training on how to prevent the spread of infection, by a infection control nurse that visited the home. Silverdale House Care Home DS0000008790.V345952.R01.S.doc Version 5.2 Page 18 The hallways and some bedrooms have been redecorated. Square tiles that were missing from the ceiling in one of the bathrooms have now been replaced. A relative has helped to tidy up the garden, which now provides residents with a pleasant and relaxing place to sit and also, a resident explained, a place of interest to look out to from the comfort of the lounge to watch the birds feed off the new bird table. Silverdale House Care Home DS0000008790.V345952.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing arrangements have dramatically improved at the home, which means residents can now be assured they are in safe hands at all times. EVIDENCE: Both relatives and residents made very positive comments about the staff team, which included they are “very friendly”, “marvellous”, and they “seem to care for their clients a great deal and the clients respond well to them”. A staff member explained that increasing the number of staff on shift has been positive because there is now time to help residents get up for breakfast, and to provide better care to people in their own bedrooms. A resident states in a survey, “in [her] experience [staff] respond quickly when anyone needs help”. Residents spoken with during the inspection all said that assistance is available when you need it. Staff members spoken with talked about the training they have recently been on and reported they are up to date with mandatory health and safety training such as fire safety, food hygiene and first aid. Four staff files examined contained training certificates, which confirmed this. There are distancelearning courses being accessed in palliative care, medicines and dementia care. The registered manager reported that six staff members are doing Silverdale House Care Home DS0000008790.V345952.R01.S.doc Version 5.2 Page 20 National Vocational Qualification (NVQ) level 3 in Social Care while all other staff members except two either have or are in the process of doing their NVQ level 2. The four staff files contained evidence that two written references and criminal record bureau check had been obtained for all four staff, before they commenced their employment. Silverdale House Care Home DS0000008790.V345952.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Sustained and improved management arrangements at the home mean the home is now well run and in the best interests of residents. EVIDENCE: Since the last key inspection the manager of Silverdale has been registered with the Commission. Evidence in this inspection report indicates that the manager has worked very hard in the last nine months to improve the quality of the service, and ensure the needs and welfare of residents are met. A relative spoken with described the manager as “having the edge on it all.” The relative has observed tighter systems in place and appreciates why she is asked to sign in money that she leaves for her relative-in-care. All residents Silverdale House Care Home DS0000008790.V345952.R01.S.doc Version 5.2 Page 22 spoken with said that they have access to money when they need it and have a lockable facility for their personal valuable possessions. There is now a fully effective quality monitoring procedure in place. The manager and deputy manager carry out their own internal audits on a three monthly basis and feedback questionnaires are sent out to residents, relatives and healthcare professionals. Graphs have already been developed to give a quick picture of results of the first two audits. The manager intends to write a general report at the end of the year summarising the findings of all the audits and feedback, which will be available to residents and other stakeholders. The home has recently had a visit from the local fire service, in which no issues were identified. There is an up to date fire risk assessment, which it is confirmed in the document that any action required as a result of the fire risk assessment has been taken. The staff team have had up to date fire safety training. Records seen during the inspection indicate that hoists and other gas and electrical systems are serviced and maintained as required by health and safety legislation. Silverdale House Care Home DS0000008790.V345952.R01.S.doc Version 5.2 Page 23 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 3 3 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X 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 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Silverdale House Care Home DS0000008790.V345952.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? YES 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 OP7 Regulation 15 Requirement Timescale for action 01/12/07 2 OP9 13(2) Care plans must clearly reflect residents’ individual current needs and wishes, and support being given to meet these needs and wishes. This ensures care is person-centred and that individual needs are identified and met. Ensure all residents that have ‘as 01/11/07 required’ medication for controlling anxiety and behaviour that there are clear and detailed care plans evidencing consent and stating when it becomes necessary for this medicine to be administered. This is an outstanding requirement from previous key inspection, initial timescale 20/06/07. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Silverdale House Care Home DS0000008790.V345952.R01.S.doc Version 5.2 Page 25 No. Refer to Standard Good Practice Recommendations Silverdale House Care Home DS0000008790.V345952.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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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