CARE HOME ADULTS 18-65
Silverdene Silverdene 709 Moston Lane Moston Manchester M40 5QD Lead Inspector
Ann Connolly Unannounced Inspection 10:00 5 January 2006
th Silverdene DS0000021710.V263829.R01.S.doc Version 5.0 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.V263829.R01.S.doc Version 5.0 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.V263829.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Silverdene Address Silverdene 709 Moston Lane Moston Manchester M40 5QD 0161 682 4901 0161 682 4901 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 4 Category(ies) of Learning disability (3), Physical disability (1) registration, with number of places Silverdene DS0000021710.V263829.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. Should the resident requiring care by reason of physical disablement no longer be accommodated then that place will revert to the category of Learning disability (LD). Staffing levels to be reviewed regularly to ensure that they are adequate to meet the needs of the services users accommodated. The manager must receive updated training in the safe handling of medication by 30 June 2005. 1st June 2005 Date of last inspection Brief Description of the Service: Silverdene is a privately owned residential home providing 24 hours personal care and accommodation for three 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 very much as part of the family. The style of the property is a large dorma bungalow with residents’ accommodation all being at ground floor level. All bedrooms were single and furnished to a very high standard. One room has a purpose built en-suite shower room to meet the needs of the individual service user. One large lounge area was available for residents to use. A well-fitted kitchen and dining area was available which led out to a separate utility area to accommodate the laundry facilities. Silverdene DS0000021710.V263829.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over the course of two and a half hours on 5 January 2006. During the inspection, time was spent talking to the four residents who live at the home, the manager and two members of staff to find out their views of the service. Time was also spent looking at medication, the care plan files and health and safety issues. A tour of the building also took place. During this inspection only a selection of the key National Minimum Standards were assessed. In order to gain a full picture of how the home meets the needs of residents, this report should be read together with any previous reports. What the service does well: What has improved since the last inspection?
The home has made a lot of progress in helping residents to develop links with the local community resources. There had also been a lot more emphasis on asking residents about their interests and co-ordinating activities to meet these needs. The home has increased staffing levels with the sole purpose of providing additional one to one support to take residents out to the local gym, shopping trips, cinema visits and day trips out to places of local interest. Residents
Silverdene DS0000021710.V263829.R01.S.doc Version 5.0 Page 6 confirmed that they were involved in a lot more activities, and said that they enjoyed going out. Since the last inspection the home has carried out and audit on medication systems and arranged for staff to participate in training to ensure the safe handling of medication in the home. 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. Silverdene DS0000021710.V263829.R01.S.doc Version 5.0 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.V263829.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These standards were not assessed during this inspection. Silverdene DS0000021710.V263829.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 and 9 Overall, residents in the home were encouraged to make decisions about their lives and were encouraged to participate in all aspects of life in the home. EVIDENCE: Each resident had an individual plan of care. The care plan set out the daily routines and basic support needs, and what staff needed to do to help residents live their preferred lifestyle. Regular reviews were held with each resident and included discussion about their preferred hobbies and interests, with an activity sheet listing individual goals and the support needed to achieve these goals. The reviews focused on involving residents and listening to their views about the care they receive. Silverdene DS0000021710.V263829.R01.S.doc Version 5.0 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 and 13 Residents were supported and encouraged to participate in community based social and leisure activities. The home actively encouraged residents to maintain contact with families and friends. EVIDENCE: This home has made considerable improvements in helping residents to develop links with local community resources. Residents had been consulted on their interests and the home had made an effort to identify local community resources to meet the needs of the residents in the home. One resident who was spoken to expressed an interest in keeping fit and boxing. As a result, the home had supported the resident to become a member of the local gym offering appropriate facilities, and as a result she now attends the gym twice a week. The home have appointed an additional member of staff to work 4 hours per day to assist service users in following up their interests and activities. One resident has visited the shops on a regular basis and enjoyed trips out involving meals with visits to restaurants and local eating out places. Other
Silverdene DS0000021710.V263829.R01.S.doc Version 5.0 Page 11 activities available included visits to the local cinema, Panto, and day trips to local attractions. One resident was encouraged to maintain regular weekend visits to a relative, and another resident participated in daily visits to a day centre. One resident who has experienced difficulty in becoming involved in local activities has been slowly introduced to a range of activities. The home has sensitively encouraged contact with the community by taking short rides out in the car followed by brief shopping expeditions. It was evident that the staff recognised that the resident’s daily/weekly routine was based on their individual need. The manager was aware that the needs of residents must be reviewed regularly and that any changes in need must be made in the care plan and that support and strategies of intervention must reflect those changes. Silverdene DS0000021710.V263829.R01.S.doc Version 5.0 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 The home had polices and procedures in place for the administration of medication system to keep people safe and well. EVIDENCE: Since the last inspection all medication systems had been reviewed and the home had recruited the services of an alternative supplying pharmacist. The manager said that the pharmacist had agreed to provide ‘in house’ training for all staff on a regular basis. The home were also in the process of developing polices and procedures to reflect good policy guidelines as detailed in the Royal Pharmaceutical Guidelines for Great Britain. Silverdene DS0000021710.V263829.R01.S.doc Version 5.0 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 Policies and procedures were in place to show that people are protected from abuse. EVIDENCE: Staff spoken to had a good understanding of adult protection issues, and were aware that in the event of any allegation of abuse a referral must be made to the social services and notification made to the Commission for Social Care Inspection. The home had an ‘in house’ policy on Adult Protection and were in the process of acquiring the Local Authority Multi Agency Policy including the Department of Health guidelines ‘No Secrets’. The manager was aware that training in adult protection must be ongoing for staff and that policies and procedures for good practice must be re-inforced in supervision sessions to ensure that the people using the service are fully protected at all times. Silverdene DS0000021710.V263829.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 25 Two bedrooms in the home compromised the privacy of the people occupying them. Some areas of the home presented a risk to the people living there. EVIDENCE: During this visit it was noted that since the last inspection on 1 June 2005, a conservatory had been installed to the rear of the premises to provide additional living space. The structure of the conservatory impacts on two of the existing bedrooms occupied by service users living in the home. Both bedroom windows look out into the conservatory, and both bedrooms can be viewed from the communal area in the conservatory itself. This means that the privacy of the people occupying these rooms is compromised. The home failed to consult the Commission for Social Care Inspection on the proposals to extend the premises, which would have enabled discussion to take place about the feasibility of adding the structure to the main house. During the visit there was no documentation from the planning department and local fire department to confirm that the building complied with building regulations and fire regulations.
Silverdene DS0000021710.V263829.R01.S.doc Version 5.0 Page 15 The registered manager must give written notice of to any proposals to alter or extend the premises. A requirement has been made for the registered manager to provide the Commission with records of consultations that have taken place with service users, who’s privacy have been affected by this building to evidence that they are satisfied with this arrangement and to provide the Commission with an action plan on how they intend to improve privacy in these two rooms. For example, by providing privacy blinds or replacing the glass with translucent glass. Copies of planning permission, building regulations and a fire report must also be submitted to the Commission. All these issues have been addressed to the manager in a separate letter. Silverdene DS0000021710.V263829.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These standards were not assessed during this inspection. Silverdene DS0000021710.V263829.R01.S.doc Version 5.0 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 42 The home did not fully have systems in place to ensure people’s safety. EVIDENCE: Since the last inspection the home had fitted fire doors in communal areas as required by the Greater Manchester Fire Authority. Records of safety checks carried out in the home were examined. All staff had participated in fire drills. The requirement to lock all cleaning products in a secure cupboard had not been addressed and is reiterated in this report. Building work had been carried out in the home (see standard 25) without obtaining the necessary assessments and checks as required by the fire authorities and building control which may compromise the safety of people living in the home. Silverdene DS0000021710.V263829.R01.S.doc Version 5.0 Page 18 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 X 3 X Standard No 24 25 26 27 28 29 30
STAFFING Score 2 2 X X X X X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X X X X X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Silverdene Score X X 3 X Standard No 37 38 39 40 41 42 43 Score X X X X X 1 X DS0000021710.V263829.R01.S.doc Version 5.0 Page 19 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 2. Standard YA24 YA15 Regulation 13(4)(a) 12 Requirement All cleaning products must be stored away in a lockable unit The manager must support service users in developing appropriate social and personal relationships. The registered manager must provide the Commission with records of consultations that have taken place with service users who’s privacy have been affected by this building to evidence that they are satisfied with this arrangement. You must provide the Commission with your plan to improve privacy in these two rooms, for example by providing privacy blinds or replacing the glass with translucent glass. The registered manager must provide the Commission with confirmation that the building complies with building and fire regulations. The registered manager must give written notice of to any proposals to alter or extend the premises. Timescale for action 12/02/06 12/02/06 3 YA42 12(4)(a) 21/02/06 4 YA42 13(4) (a) 21/02/06 5 YA42 39 (h) 21/02/06 Silverdene DS0000021710.V263829.R01.S.doc Version 5.0 Page 20 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 Silverdene DS0000021710.V263829.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection CSCI, Local office 9th Floor Oakland House Talbot Road Manchester M16 0PQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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