Inspection on 30/04/07 for Silverdene

This inspection was carried out on 30th April 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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Silverdene 21/11/06

Silverdene 05/01/06

Silverdene 01/06/05

Silverdene 28/02/05

Silverdene 30/06/04

Silverdene 04/03/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Silverdene 709 Moston Lane Moston Manchester M40 5QD Lead Inspector Joe Kenny Unannounced Inspection 30th April 2007 10:00 Silverdene DS0000021710.V334638.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 Silverdene DS0000021710.V334638.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. Silverdene DS0000021710.V334638.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Silverdene Address 709 Moston Lane Moston Manchester M40 5QD 0161 682 4901 F/P 0161 682 4901 dannyhughes11@btinternet.com 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 Maria Hughes Mrs Maria Hughes Care Home 7 Category(ies) of Learning disability (7), Physical disability (1) registration, with number of places Silverdene DS0000021710.V334638.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. A maximum of 7 service users can be accommodated at any one time. One named service user is physically disabled (PD). Should this service user no longer be accommodated then the place shall revert to Learning Disability (LD). 21st November 2006 Date of last inspection Brief Description of the Service: Silverdene is a privately owned residential home which is registered to provide personal care and accommodation for six people with a learning disability and one person with a physical disability. The accommodation is also part of the registered providers family home and residents are treated as part of the family. The property is a large dorma bungalow with a separate detached property, which has been recently built to the rear of the main house. The main house can accommodate 5 residents in ground floor single rooms and the detached external extension building can accommodate a further 2 residents. All bedrooms are single and are furnished to a very high standard. One room has a purpose built en-suite shower room to meet the needs of the individual resident. One large lounge area was available for residents to use. A wellfitted kitchen and dining area was available which led out to a separate utility area to accommodate the laundry facilities. Silverdene DS0000021710.V334638.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The visit to the home was carried out unannounced and took place on the 30 April 2007. This visit provided the opportunity to look at National Minimum Standards for care homes supporting people with a learning disability to determine how the home is meeting required standards. Prior to the visit the Commission had received information from the home as well as information from people living in the home who completed and returned comment cards about the service they received. On the day of the visit time was spent examining records, people’s care plans, staff information and time was spent speaking to staff and people who lived at the home. The home had taken appropriate action to address the requirement and recommendations made as a result of previous visits. A tour of the building and grounds was also undertaken. The fees for the home are £500 to £750 per week. What the service does well: The day to day running of the home is conducted in the best interest of people who live there. There was a real feeling of homeliness from observations and discussions with people living there and from staff who supported them. Day to day living and social arrangements reflected the choices of people who live there. There was evidence of people freely accessing community resources with the help of staff. People returning form such activities, spoke about how they enjoyed the event and about where they went. Meals are planned, prepared and served at the times chosen by people living at the home. The menu plan reflected the diverse preferences of people and staff stated they would respect people’s preferences and choices at meal time. The design and lay out of the home ensures people have access to spacious communal areas and individual bedrooms which reflected their personal interests and a number of rooms which clearly addressed the health care needs of individuals. There was a clear commitment by the manager and administrative staff to review and develop recording systems and procedures to reflect and evidence the high standard of care being offered at the home. Silverdene DS0000021710.V334638.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Silverdene DS0000021710.V334638.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 Silverdene DS0000021710.V334638.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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home are provided with the information they need to ensure the home meets their assessed needs. EVIDENCE: There were six people living in the home at the time of the inspection. Two people had moved to the home since the last inspection. The records relating to the individuals from the time of their admission were informative and assisted the home in planning how they should be supported. The manager stated a further person had been moved to the home between the times of inspections and had since moved following a review of the placement. Each individual had a file which contained a number of sections relating to personal information, assessments, care planning and reviews. Each file had a copy of the homes statement of purpose and a service user guide; the guide was specific to the individual with a photo of the individual and their name on the front page. The manager and staff confirmed that all persons receiving support at the home are provided with their own individual service users guide. Silverdene DS0000021710.V334638.R01.S.doc Version 5.2 Page 9 A large section of the files are developed in pictorial formats which are very easy to understand and clearly indicated what each section refers to, such as activities, health issues and personal gaols. The manager and staff spoke about what happens when a person is referred to the home. This includes visits to meet the person in their previous setting, gathering information from the person’s social worker, next of kin and person considering moving to the home. The admission process also includes the opportunity for the person to visit the home prior to moving there. The manager was advised to develop a pre-admission form to assist in evidencing how staff from the home gather information to assist in the development of the homes care planning process. Six completed comment cards were returned to the inspector. All confirmed that they were provided with information about the home before they moved there. One person clearly indicated they requested to move to the home. Silverdene DS0000021710.V334638.R01.S.doc Version 5.2 Page 10 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): 6,7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The needs, choices and abilities of people living in the home are assessed and people are supported to achieve independent lifestyles. EVIDENCE: Care files contained information from the time of admission and clearly set out the level of support and care each person required. People living in the home are supported by a named member of staff who will be their key worker. The levels of support and care required by individuals varied to a significant degree. Staff maintained daily records of the support they provided to individuals. This information was clearly written and entries were made on a daily basis. The records of the four people who have resided at the home for a number of years were well established and people indicated they were happy with the support they received from staff since they moved to the home. Silverdene DS0000021710.V334638.R01.S.doc Version 5.2 Page 11 On examination of the files of the two people recently admitted, the manager was advised to develop records relating to a area of risk for one of the people. Specific areas of risk were discussed with the manager and administration staff. Staff stated they would take appropriate steps to address development of these records. Care plans continue to be reviewed by the person’s key worker. Staff also spoke about developing and reviewing care plans into a more person centred approach. The person centred documents were on file and had been contributed to by staff. During discussions with staff they were advised to ensure the recorded information reflected the preferences and language used by each individual. Examples of recorded information and possible alternatives which were more person centred were discussed with staff. The home had taken appropriate steps to ensure the files of people living in the home were held securely and confidentially in accordance with Data Protection procedures. People can access their own files with the support of their key worker. A good example of records related to the homes hospital admission form. This document would be taken by staff when escorting people to hospital and contained a brief but concise record of information about the person, their health care needs, list of medication and any known allergies. Silverdene DS0000021710.V334638.R01.S.doc Version 5.2 Page 12 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): 12, 13, 15, 16 and 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The arrangements for daily living reflected the choices, abilities and preferences of people in relation to domestic and social arrangements. EVIDENCE: From discussions with people living in the home and observations made on the day it was evident that people are free to plan how they spent the day. Staff were available to support people wishing to go out on trips, walks or shopping. It was also evident that social events and trips out reflected the personal interests of people. The home had recently purchased a minibus which would be used by people living at the home for greater access to places of interest. The home is within easy access to shopping areas such as Moston and Harpurhey. Bus stops are located outside the home and a public recreational park is located on the opposite side of the road to the home. Silverdene DS0000021710.V334638.R01.S.doc Version 5.2 Page 13 Personal plans also contained information about daily activities chosen by the individuals and included activities in the home and in the community. Meal and menu plans reflected individual preferences and staff confirmed that people were offered a range of meals to choose from. It was encouraging to note that people could also choose what time they preferred to eat. This was evident when observing a person take a late mid day snack following a period of planned rest. Each person’s file has a copy of their menu plan. Staff had received appropriate training in basic food hygiene procedures as they are responsible for preparing meals. Silverdene DS0000021710.V334638.R01.S.doc Version 5.2 Page 14 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): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s personal and health care needs were being met by the home. Medication procedures protected people. EVIDENCE: The files relating to three people were examined and contained evidence that the personal and health care arrangements were appropriate to meeting people’s assessed needs. Each file contained details of the person’s general practitioner and other health professionals involved in their health care. Arrangements for personal care and support are detailed in care plans and inform staff of the levels of support each individual requires. Individual health and support plans were found to be very detailed but some forms did not record the date they were drawn up. The home is advised to ensure all documents are dated to assist in the monitoring and review process. Silverdene DS0000021710.V334638.R01.S.doc Version 5.2 Page 15 Rooms are spacious and support is offered in the privacy of the person’s own bedroom. Two people being supported have access to bathing and toilet facilities in their own room. Staff spoke about their work and how they supported people as key worker. Staff demonstrated a clear understanding of the care and support required by people living in the home. Medication procedures have been reviewed to ensure medication is stored in a secure metal cabinet. The key to the cabinet is held by the registered manager or senior member of staff when on duty. The home uses the Venolink system. Medication procedures, records and an audit of medication was carried out and all systems and records were found to be in order. Where a person may refuse medication, the home must keep a record on the medication administration record using the appropriate code. The home does not hold homely remedies. All medication is prescribed by the person’s general practitioner. Silverdene DS0000021710.V334638.R01.S.doc Version 5.2 Page 16 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): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People had access to information about how to make complaints. Procedures were in place to protect residents from abuse. EVIDENCE: The home’s complaints procedure is located in the person’s individual service user guide. The information had been amended to inform people of the recent change of address of the Commission for Social Care Inspection. The home had not received any complaints in the period since the last inspection. The home had introduced a complaints register to record any complaints it may receive. During discussion with staff they demonstrated an awareness of the principles and procedures regarding adult protection. The manager stated that staff had attended a refresher course on abuse awareness. Further discussions on the topic identified a need for staff to ensure procedures relating to recording of information following a disclosure did not result in the home taking steps to investigate the allegation of abuse. This remains the responsibility of the local authority. The home had a copy of the Local Authority Multi Agency Policy and was advised to retain evidence that all staff had the opportunity to read this document. Silverdene DS0000021710.V334638.R01.S.doc Version 5.2 Page 17 Records relating to residents’ finances and how they are managed on their behalf were well documented. People had their own bank accounts and received support from their key worker to carry out transactions. The home is advised to develop procedures and recording systems in relation to handling people’s bank cards. Silverdene DS0000021710.V334638.R01.S.doc Version 5.2 Page 18 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): 24 and 30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People live in a homely, clean, well maintained and safe environment. EVIDENCE: The grounds to the home are well maintained, spacious and offer people a pleasant and secure external setting. The standard of decorating and facilities available to people living in the home is equally to a very high standard. There was a very evident relaxed and homely feeling in the home. The two bed roomed unit on the grounds offer secure, accessible and private accommodation. A tour of the home was conducted, which included all bedrooms and communal areas. Bedrooms were very spacious, personalised and decorated and furnished to an exceptionally high standard. Rooms reflected people interests Silverdene DS0000021710.V334638.R01.S.doc Version 5.2 Page 19 and all rooms are fitted with wall mounted flat TV screens linked to satellite networks. During informal discussions with people about the home all indicated they were very happy with the home they lived in. Silverdene DS0000021710.V334638.R01.S.doc Version 5.2 Page 20 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): 32,34, and 35. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staffing arrangements were appropriate to meeting peoples assessed needs. Staff had the necessary skills and experience to support people living in the home. EVIDENCE: The staffing arrangements for the home were appropriate to meeting the varying degrees of support and care required by people living in the home. The registered owner and manager resides on site and is supported by other family members and contracted staff in the delivery of care and support. The improved support offered to people to access community resources and chosen leisure interests, continued to be addressed through daily and weekly social and leisure interests. On the day of this visit people were seen to go out with support from staff and when returned spoke about where they had been and how they had enjoyed themselves. Silverdene DS0000021710.V334638.R01.S.doc Version 5.2 Page 21 People who stayed in the home did so by choice or as a result of the support and care they required. The support and attention they received met their needs and one person who required regular support and assistance spoke affectionately about the home and the care she received. Staff spoke about how they supported people as named key worker and records maintained by staff were informative and evidenced the support offered. Staff files contained information from the time of applying to be a support worker and records of reference checks and CRB checks being made. A member of staff employed to offer administrative support to the home spoke about her role in developing recording systems and organising training programmes for staff. The manager meets with staff through their day to day work and holds formal supervision sessions every three months. Records were available to evidence supervision is provided to staff. Training information confirmed all staff had completed or were in the process of completing NVQ training II and above. Silverdene DS0000021710.V334638.R01.S.doc Version 5.2 Page 22 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): 37, 39 and 42. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The management and administration procedures ensure the home is operated in the best interest of people who live there. EVIDENCE: The manager had the necessary experience and qualifications to run the home and has been registered as owner of the home for a number of years. Records relating to staff evidenced that people working in the home had the necessary experience, skills and support. Staff interacted very positively with all people living in the home. The views of people living in the home are regularly monitored and reviewed by key workers as they meet with people to discuss the support and care they receive on a monthly basis. Silverdene DS0000021710.V334638.R01.S.doc Version 5.2 Page 23 There were clear procedures in place to inform and support people moving to the home and supporting documentation to evidence how their needs were being met. Records relating to health and safety checks within the home were examined on the day and were found to be well maintained and in order for the protection of staff and people living at the home. The last recorded fire drill was on the 21 September 2006. The manager was advised to conduct a further drill in the period following this visit and advised to ask staff to sign the fire register in person. Silverdene DS0000021710.V334638.R01.S.doc Version 5.2 Page 24 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 4 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 4 33 X 34 4 35 4 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 4 13 4 14 X 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 X 3 X X 3 X Silverdene DS0000021710.V334638.R01.S.doc Version 5.2 Page 25 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 YA20 Regulation 13 Requirement Where a person may refuse medication, the home must keep a record of the medication on a medication administration record and maintain a signed record, using the appropriate code where medication is refused. Timescale for action 22/06/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard YA3 YA6 YA6 YA42 Good Practice Recommendations The manager was advised to develop a pre-admission form to assist in the development of the homes care planning process. The manager is advised to develop records relating to an area of risk for one of the people identified at the time of the inspection. The home is advised to ensure individual health and support plans record the date they were drawn up to assist in the monitoring and review process. The manager was advised to conduct a further fire drill in the period following this visit and advised to ask staff to sign the fire register in person. DS0000021710.V334638.R01.S.doc Version 5.2 Page 26 Silverdene Commission for Social Care Inspection North West Regional Office 11th Floor West Point 501 Chester Road Old Trafford M16 9HU 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. Extracts may not be used or reproduced without the express permission of CSCI Silverdene DS0000021710.V334638.R01.S.doc Version 5.2 Page 27 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!