Inspection on 20/02/07 for Silverlea Residential Home

This inspection was carried out on 20th February 2007.

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

Silverlea Residential Home 21/01/08

Silverlea Residential Home 18/07/07

Silverlea Residential Home 15/06/06

Silverlea Residential Home 02/03/06

Silverlea Residential Home 09/06/05

Silverlea Residential Home 09/11/04

Similar services:

Snydale Care Home

Abbey The

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Silverlea Residential Home 3 First Avenue Bradford Moor Bradford West Yorkshire BD3 7JG Lead Inspector Steve Marsh Key Unannounced Inspection 20th February 2007 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Silverlea Residential Home DS0000061674.V325252.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. Silverlea Residential Home DS0000061674.V325252.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Silverlea Residential Home Address 3 First Avenue Bradford Moor Bradford West Yorkshire BD3 7JG 01274 661700 01274 660611 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) Mr Kevin Casey *** Post Vacant *** Care Home 35 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (35), of places Physical disability over 65 years of age (3) Silverlea Residential Home DS0000061674.V325252.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th June 2006 Brief Description of the Service: Silverlea Care Home is a large detached adapted property, located in the Bradford Moor area, overlooking the park and about one mile from the city centre. The home is registered to provide personal care for thirty-five residents in both single and double bedrooms, situated on all four floors of the building. There are steps to the front of the home. There is however level access to the rear of the property, and a passenger lift to all floors. Externally there is a patio area to the front of the property, which the service users are able to use during the summer months. The home is on a main bus route from the city centre and there is street parking to the front of the property. The fees range from £318.14p to £354.75p per week (£365.00 for self funding clients). Additional charges are made for services such as hairdressing, newspapers, private chiropody, outings and the sweet trolley. Silverlea Residential Home DS0000061674.V325252.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. In April 2006 the Commission for Social Care Inspection (CSCI) made some changes to the way in which care homes are inspected. Care services are now judged against outcome groups. The inspection report is divided into separate sections for each outcome group for example Choice of Home, Health and Personal Care etc. An overall judgement reflects how well the home delivers outcomes to the people using the service. The judgement categories are “excellent”, “good”, “adequate” and “poor”. The judgements are recorded in the body of the report. More detailed information about these changes is available on website – www.csci.org.uk This unannounced inspection was carried out between the hours of 9:00am and 5:00pm. The manager left earlier in the year and Mrs Jean Marlow was appointed manager on the 19 February 2007. Mrs Marlow has many years experience in the caring profession and this is the second time she has managed Silverlea Care Home. The last key inspection was in June 2006 and there were twenty-six requirements and two recommendations made at that time. A random inspection was carried out in November 2006, during which I looked at the following areas of concern: • • • • • Refurbishment Fire Safety Sluicing facilities Adult Protection Registration (Manager) The purpose of this inspection was to assess what progress the service has made in meeting requirements and to assess the impact of any changes in the quality of life experienced by people living at the home. The methods I used included looking at records, watching staff at work and seeing how care was given to the residents, talking with residents and staff and looking round the home. Questionnaires were given to residents and relatives so that they could share their views of the service with the Commission. Unfortunately no questionnaires were returned before this report was completed. Detailed feedback was given to the manager at the end of the visit. Silverlea Residential Home DS0000061674.V325252.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: The home must make sure that prospective residents receive up to date information about the home so that people can make an informed choice about moving in to the home. Silverlea Residential Home DS0000061674.V325252.R01.S.doc Version 5.2 Page 7 The home must make sure that care plans accurately reflect the resident’s present circumstances and are reviewed at least monthly. The present care planning system should also be reviewed and care plans made easier for staff to use. Care plans should be clearly written giving direction to staff about what care and support each resident needs and how they prefer their care needs to be met. Moving and handling plans must also be updated and reviewed on a regular basis so that residents that cannot walk or move independently are given appropriate support from staff using the right equipment. A stock control is required for PRN (as and when required) medication and the small fridge used for the storage of medication needs to be moved from the top of the drug trolley as it could be knocked off and injure a resident or member of staff. The Registered Provider must make sure that all complaints are investigated within the timescales set out in the complaints procedure so that people do not lose confidence in the way complaints are dealt with. The home needs extensive refurbishment both to improve the residents’ quality of life and to make sure their health and safety is not put at risk. Although some work has started progress is very slow and the timescales given to us by the provider are continually extended. Staffing levels only just meet the minimum requirements and therefore they need to be reviewed to make sure that the home can be managed effectively and the residents receive the care and support they need at all times. The home must make sure Criminal Record Bureau (CRB) checks are obtained for all existing staff and employment files are available for inspection, so that residents can be sure that staff that are working at the home are suitable and recruited properly. The home needs to carry out a full staff-training audit and make sure training records are available for inspection. A training programme must also be put in place. This will make sure that staff have the skills and competences they need to meet the residents’ needs. Quality assurance monitoring systems must be put in place and the views and opinions of the residents must be sought to make sure that their experience of living at the home lives up to their expectations. The home must make sure that all financial transaction sheets are up to date to protect the residents from financial abuse. The manager must make sure that risk assessments for the building are completed and up to date, to make sure the residents live in a safe and secure environment. Silverlea Residential Home DS0000061674.V325252.R01.S.doc Version 5.2 Page 8 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. Silverlea Residential Home DS0000061674.V325252.R01.S.doc Version 5.2 Page 9 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 Silverlea Residential Home DS0000061674.V325252.R01.S.doc Version 5.2 Page 10 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, 3, 4 and 5 – Standard 6 does not apply to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. However, the service users guide must be made available to prospective residents and relatives to give them the opportunity to decide whether or not the home can meet their needs. The admission procedure is thorough and a resident will not be admitted unless staff are able to meet their needs. EVIDENCE: The home’s service user guide was last reviewed in 2006, however the document now needs amending to reflect the change in manager and senior staff team. Copies of the service user guide are not being made available to prospective residents. Silverlea Residential Home DS0000061674.V325252.R01.S.doc Version 5.2 Page 11 I reminded the manager that the purpose of the document is to give prospective residents information about the service, which will assist them when choosing a home and therefore copies should be available. The care records show that staff carry out pre-admission assessments by visiting prospective residents in their own homes or temporary place of residence. This means that staff can be sure they can meet the residents’ needs before they are accepted into the home. Prospective residents and their relatives are always invited to visit the home before admission so they can look round, meet other residents and staff and stay for a meal, this helps them decide if they want to move in. Residents are also able to move into the home for a trial period so that they can experience first hand the standard of care and facilities provided. Records showed that residents and their families are supported throughout the admission process and care is taken in helping residents settle at the home. One resident recently admitted to the home for respite care said although she had been unable to visit the home before admission she was happy with the standard of care provided. The resident had not been provided with a copy of the service user guide and therefore had no idea of the range of services or the level of care provided by the home before admission. The home does not provide intermediate care. Silverlea Residential Home DS0000061674.V325252.R01.S.doc Version 5.2 Page 12 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. Care records including care plans and moving and handling assessments do not provide accurate and up to date information, which means that residents may not receive the support and care they need from staff to meet their health, personal and social care needs. EVIDENCE: Care plans are in place for all residents and there is evidence to show that residents and relatives are involved in the care planning process. However, six care plans I looked at had not been reviewed since September/October 2006 and therefore did not accurately reflect the level of care required by the service users’. In one case the care plan for a resident exhibiting behavioural problems had not been reviewed since September 2006 even though the daily reports showed that staff were having more difficulty managing her behaviour. Silverlea Residential Home DS0000061674.V325252.R01.S.doc Version 5.2 Page 13 The moving and handling plans for three other residents had also not been reviewed for since September/October 2006. Therefore, there is a risk resident’s and staff could be put at risk of injury by the wrong equipment or technique being used. The care planning system is now in an extremely poor state and the failure to keep accurate care records means that it is not certain that residents are receiving the care and support they need. On discussing this matter with senior staff it is apparent that present staffing levels mean that they spend the majority of their time providing “hands on” care and are struggling to up date the care plans. The poor care plans were discussed with the manager at the last key inspection and there has been no improvement in addressing this matter. The care plan system is complex and difficult for staff to follow and maintain. Care plans should be clearly written giving direction to staff about what care and support each resident needs and how they prefer their care needs to be met. The care plans must be kept up to date and should be used by staff as working documents so that the residents can be sure that they will receive consistent and appropriate care. All residents are registered with a general practitioner and have access to the full range of NHS services. The input of other healthcare workers is recorded and shows that staff are seeking professional help if they have any concerns. Since the last key inspection two comment cards have been received from general practitioners who visit the home; they showed that overall they were satisfied with the care provided. During the inspection I had a brief discussion with a district nurse who confirmed that the district nursing service are working with the staff team to maintain and improve the standard of care received by the residents. Residents confirmed that they were pleased with the standard of healthcare they received and said that prompt medical attention was provided both during the day and night. I spent time talking with the residents and watching how staff carried out their work it was clear that the residents’ privacy and dignity is respected and assistance with personal care is carried out in a discreet and sensitive manner. Some improvements have been made to the medication system although a stock control system is still required for PRN (as and when required) medication to show that it is being held and administered safely. Silverlea Residential Home DS0000061674.V325252.R01.S.doc Version 5.2 Page 14 The small fridge used for storing medication also requires moving from the top of the drug cabinet, as it may get knocked off and injure a resident or member of staff. Silverlea Residential Home DS0000061674.V325252.R01.S.doc Version 5.2 Page 15 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 adequate. This judgement has been made using available evidence including a visit to this service. The home responds to individual needs and choices and encourages residents to exercise control over their daily lives. Although the home arranges some activities and outings more could be done to provide the residents with a stimulating environment and a full and active social life. EVIDENCE: Residents said that the daily routines at the home were flexible and that they are encouraged by staff to make as many decisions as possible about their daily lifestyle. A new part time activities co-ordinator was recently appointed, who will be responsible for arranging activities, outings and entertainment for the residents. However as the activities organiser only works twelve hours a week the care staff are responsible for organising activities when she is not on duty. Silverlea Residential Home DS0000061674.V325252.R01.S.doc Version 5.2 Page 16 Residents confirmed that generally they were happy with the level of activities organised for them although some said that the home was often short staffed and therefore no activities were organised. At present local church leaders do not visit the home although arrangements can be made for individuals to attend a place of worship and one resident attends church on a regular basis. The manager confirmed that it is her intention to look at ways of improving links with local community groups and getting residents more involved in community events. Residents said that they were able to see visitors in their own room and family and friends were always made to feel welcome by the staff and offered light refreshments. The meals at the home were described by the residents as generally good although one resident felt that the portions were small and the choice limited. The portions served at lunchtime although not large were satisfactory and the food was well presented. I spoke to the cook who confirmed that she was aware of the individual residents’ preferences and tried to cater for them accordingly. Menus showed that a choice of meals is available at both lunch and teatime and the cook confirmed that special diets could be catered for on request. The dining room has recently been refurbished and new tables and chairs purchased. This has created a better environment, however several residents complained that the dining chairs were too low and they needed to sit on cushions to reach the table. Silverlea Residential Home DS0000061674.V325252.R01.S.doc Version 5.2 Page 17 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 adequate. This judgement has been made using available evidence including a visit to this service. Residents appear to have regained some confidence in the home’s complaints procedure and now feel that the manager will listen to their concerns/complaints and address matters. However, the failure of the Registered Provider to respond to complaints within appropriate timescales is not acceptable and still raises concerns about the way complaints are dealt with. EVIDENCE: The home has a complaints procedure and residents said that if they had any concerns they would feel able to raise them with the manager. We have received two complaints since the last inspection. On the 8 January 2007 the complaints were referred back to the Registered Provider to investigate using the home’s complaints procedure. Up to the date of inspection we have received no details about the findings of the investigations. Policies and procedures are in place about the protection of vulnerable adults and there is an ongoing programme of adult protection training. Staff confirmed that they were aware of the home’s policy on “whistle blowing” and their responsibility to protect the residents from any form of abuse. Silverlea Residential Home DS0000061674.V325252.R01.S.doc Version 5.2 Page 18 The manager has a good understanding of how to use Bradford multi–agency adult protection procedures and the Protection Of Vulnerable Adults (POVA) register. Silverlea Residential Home DS0000061674.V325252.R01.S.doc Version 5.2 Page 19 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): 19, 20, 21, 22, 24, 25 and 26 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The home continues to require extensive refurbishment, both to improve the residents’ quality of life and to ensure their health and safety is not compromised. EVIDENCE: Following the last key inspection in June 2006 the Registered Provider was required to provide us with an improvement plan setting out timescale for the refurbishment of the home, including the completion of outstanding fire safety work. In July 2006 a letter was sent to the Registered Provider clarifying the work to be completed and accepting the timescales given of 30 November 2006. The random inspection visit on the 7 November 2006 showed that very little work had been completed. Silverlea Residential Home DS0000061674.V325252.R01.S.doc Version 5.2 Page 20 The main reason for the lack of progress seemed to be that only one person was carrying out the majority of work. We met with the Registered Provider in January 2007 and it was agreed that the new timescale for completion of the refurbishment work would be the end of May 2007 and that additional resources would be brought in to make sure that the work was completed on time. On this visit progress remains very slow and as there continues to be only one person employed to do the work it is difficult to see how the refurbishment programme will be completed on time. All the communal areas are on the ground floor of the home and consist of four lounges, one of which is a designated smoking lounge and a dining room. Since the last inspection a new floor covering as been laid in the dining room and new tables and chairs purchased which has improved the room making it more comfortable and pleasant for the residents. The standard of décor in the communal areas is satisfactory although some rooms would benefit from decorating and/or generally brightening up. Bedrooms are situated on all four floors of the home and consist of both double and single rooms. Many of the rooms still require refurbishing and old damaged furniture replacing. A number of seals have gone in double glazed units in the bedroom windows causing condensation and therefore they require re-glazing so that residents can see out. Appropriate locks have not been fitted to some bedroom doors. Some new bedding has recently been purchased but a number of duvets still need replacing, as they are thin and worn. The carpet on the main staircase is threadbare in places and requires replacing as part of the refurbishment programme. Call alarms are located in every bedroom, however the alarm only sounds on the ground floor of the building and not on every floor as required. This means that if staff are not working on the ground floor they won’t be aware that a call bell is ringing. The home must therefore look at providing additional sounders on all floors or providing staff with bleepers to alert them when the alarm is activated. The intercom system also allows staff to speak to residents in their rooms but could compromise their right to privacy as staff are able to listen in on private conversations if the intercom system is accidentally left on in their room. This matter must also be addressed when the system is upgraded and a way found to protect the residents right to privacy. Silverlea Residential Home DS0000061674.V325252.R01.S.doc Version 5.2 Page 21 The kitchen still requires a deep clean, decorating and more effective fly screens fitting to windows. The laundry still requires decorating and a new impermeable floor covering as part of the refurbishment programme. Work to install a sluicing facility in a room adjacent to the laundry was due to start the week following the date of inspection. As the home still does not have a sluice and the washing machines do not have a sluice programme there continues to be a high risk of cross infection occurring. On the day of the visit the standard of cleanliness and hygiene in some areas of the home was poor, which the manager acknowledged. Toilets and bathrooms in particular were dirty and in at least four toilets no soap or disposable towels were available. Silverlea Residential Home DS0000061674.V325252.R01.S.doc Version 5.2 Page 22 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 poor. This judgement has been made using available evidence including a visit to this service. Staffing levels are at a minimum and need to be reviewed to make sure that the home can be managed effectively and the residents receive the care and support they need at all times. Criminal Record Bureau checks have still not been carried out for some staff, which puts residents at risk of being cared for by staff that are not suitable to work with older people. The lack of training records means that there is no evidence to show that the staff have the skills and experience they require to meet the needs of the residents. EVIDENCE: The staff rota showed that on day and night duty the home continue to just meet the minimum staffing levels with little cover available for staff sickness and/or annual leave. It is apparent that the present staffing levels are making it very difficult for the manager and senior staff to effectively manage the home as they are spending the majority of their time providing “hands on” care and therefore are not able Silverlea Residential Home DS0000061674.V325252.R01.S.doc Version 5.2 Page 23 to keep the paperwork up to date. Staffing levels must be reviewed and increased accordingly. The home is currently recruiting a part time clerical assistant to assist the manager reorganise the office and take on some general administrative duties, however the senior staff will continue to maintain all care records. Cleaning staff are employed, although on the day of inspection the standard of cleanliness in some areas of the home was poor. I discussed this with the manager who said that there are enough cleaning hours but the staff have lacked supervision and guidance, resulting in the present poor standards. The manager is currently addressing this matter. Two cooks are employed, however the home no longer employs a kitchen assistant and therefore it is now the responsibility of the cooks to ensure that hygiene standards are maintained in the kitchen. One new staff had been employed since the last inspection and the employment file showed that the recruitment and selection procedure had been thorough. Two written references and a Criminal Record Bureau (CRB) check had been obtained before she started work. However, there was no employment file available for the new manager and no CRB checks have yet been obtained for three long serving staff. The failure to obtain satisfactory CRB checks for all staff highlights the home’s poor record of protecting residents by making sure that the staff employed are suitable and safe to work with older people. The manager also confirmed that no staff have yet received contracts of employments although they do have job descriptions, which outline their roles and responsibilities. No staff training records could be found on the day of inspection and therefore there was no evidence to show that the staff have the skills they need to care for the residents. At present seven staff have achieved a National Vocational Qualification (NVQ) at level two and a further five are registered to start the course. The manager is in the process of arranging additional training for the staff on topics such as infection control and medication. The manager is also arranging a moving and handling course, as she is aware that currently about only 50 of staff have completed practical moving and handling training. It is important that all staff complete at least mandatory training such as moving and handling as soon as possible so that residents are cared for safely by skilled and competent staff. Silverlea Residential Home DS0000061674.V325252.R01.S.doc Version 5.2 Page 24 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, 32, 33, 35, 36, 37 and 38 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The lack of effective quality assurance monitoring systems means that the residents are unable to air their views and opinions about the standard of care they receive. Records and reports relating to the care of the residents, staff employment and the management of the home are not stored securely within the present filing system, which has lead to important documents being misplaced or lost. EVIDENCE: The previous manager left the home earlier in the year and Mrs Jean Marlow was appointed manager the day before the inspection visit. Mrs Marlow has Silverlea Residential Home DS0000061674.V325252.R01.S.doc Version 5.2 Page 25 many years experience in the caring profession and this is the second time she has managed Silverlea Care Home. Mrs Marlow has not yet achieved a NVQ in management and care (or equivalent), however it is anticipated that she will start studying for the award in the near future. Talking with staff it is apparent that morale at the home has recently been poor. While this does not appear to have directly affected the care provided to the residents it has meant that staff have not been working effectively as a team. The manager is aware of the recent problems and confirmed that improving staff morale and lifting team spirit is one of her first priorities. Staff confirmed that she appears to have an open and approachable management style and residents said that although they were sorry the last manager had left they were pleased that Mrs Marlow had been appointed. Concerns have been expressed in the past about the lack of communication between the Registered Provider and previous managers. It is therefore essential that a close working relationship and clear lines of accountability be established if standards at the home are to improve. To make sure there is good communication within the home the manager is to hold regular staff meetings and there is evidence that formal one-to-one staff supervision is carried out. There continues to be no quality assurance monitoring systems in place and therefore there is no way for residents or relatives to air their views and opinions of the service, other than to use the complaints procedure. Residents and/or relatives continue to be encouraged to take control of their financial affairs if at all possible although the home still holds money in safe keeping for some residents. Concerns were again raised about financial transaction sheets not being up to date, as the Registered Provider had failed to enter the residents’ personal allowances on the transaction sheet since the 19 January 2007. Record keeping at the home is poor and on the day of inspection the small office used by the manager was disorganised making it difficult to find information. This must be addressed to make sure that all records and reports are updated on a regular basis and easily accessible. Policies and procedures are in place to safeguard the health and safety of the residents, visitors, and staff. However, additional risk assessments still need to be carried out for the building and to make sure staff follow safe-working practices. Silverlea Residential Home DS0000061674.V325252.R01.S.doc Version 5.2 Page 26 The owner must provide evidence that the gas boilers and central heating system at the home have been serviced, as required in the last inspection report. Silverlea Residential Home DS0000061674.V325252.R01.S.doc Version 5.2 Page 27 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 2 X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 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 1 17 X 18 3 1 2 3 2 X 1 3 1 STAFFING Standard No Score 27 2 28 2 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 1 X 1 3 1 2 Silverlea Residential Home DS0000061674.V325252.R01.S.doc Version 5.2 Page 28 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 OP1 Regulation 4 -- 5 Requirement The registered persons must ensure that the home’s service user guide is updated and made available to both current and prospective service users. The registered persons must ensure that care plans accurately reflect the level of care to be provided and are reviewed at least monthly. The registered persons must ensure that moving and handling plans are up dated and accurately reflect the individual’s needs. A stock control system must be implemented for PRN medication. (Timescale 31/07/06 not met) The fridge used for storing medication must be moved from the top of the drug cabinet. The registered provider must ensure that all complaints are investigated within the timescales set out in the complaints procedure. The registered provider must DS0000061674.V325252.R01.S.doc Timescale for action 30/04/07 2. OP7 15 31/03/07 3. OP8 12(1) & 13(5) 31/03/07 4. OP9 13(2) 31/03/07 5. OP16 22 31/03/07 6. OP19 23 31/05/07 Page 29 Silverlea Residential Home Version 5.2 refurbish the following areas of the home: Second floor – Corridors and staircase leading to first floor. First floor – Corridor and staircase leading to ground floor. Ground Floor - Entrance and corridors. Lower Ground Floor - Corridors and staircase leading to ground floor. Main staircase – New carpet to be fitted. Bedrooms – Redecorating, refurbishment including replacing old/worn furniture. Appropriate locks must be fitted to all bedroom doors. Communal areas – Refurbish as required including replacing all old furniture. All work highlighted by the Fire Safety Officer must be included in the refurbishment programme. Outstanding from last inspection -- timescale 12/11/06 not met. The kitchen must be deep cleaned and decorated. More effective fly screens must be fitted to the kitchen windows. Outstanding from last inspection – timescale 31/08/06 not met. The emergency call system must be serviced and a copy of the test certificate must be sent to Commission. Sounders must be provided on all floors Outstanding from the last three inspection reports timescale 31/08/05, 31/05/06 and 31/08/06 not met. DS0000061674.V325252.R01.S.doc 7. OP19 23 30/04/07 8. OP22 23(2) 30/04/07 Silverlea Residential Home Version 5.2 Page 30 9. OP24 23 10. OP26 23(2)(k) Alterations to the present intercom system are also required so that staff are not able to listen in on private conversations. Outstanding from last two inspection reports - timescale 31/05/06 and 31/08/06 not met. All double glazed window units 30/04/07 must be replaced as required. Outstanding from last four inspection reports timescales 31/03/05, 31/12/05, 31/05/06 and 31/08/06 not met. The laundry area must be 30/04/07 refurbished and have a new impermeable floor covering. A sluicing facility must be provided. Outstanding from the last four inspection reports timescale 31/08/05, 31/12/05, 31/05/06 and 15/09/06 not met. The registered persons must ensure that all areas of the home are kept clean and free from offensive odours. The Registered Provider must review the current staffing levels and make sure enough staff are employed to meet residents needs and to cover for holidays and sickness. The registered persons must ensure that at least 50 of the care staff team achieve a NVQ at level two or above. Outstanding from last inspection report – timescale 31/12/06 not met. The registered persons must ensure that the employment files for all members of staff are available for inspection. DS0000061674.V325252.R01.S.doc 11. OP26 23 31/03/07 12. OP27 18 31/03/07 13. OP28 18 31/08/07 14. OP29 19 31/03/07 Silverlea Residential Home Version 5.2 Page 31 15. OP30 18 Criminal Record Bureau checks must be completed for all members of staff. Outstanding from last inspection – timescale 31/07/06 not met. The registered persons must ensure that staff training records are available. A full staff training audit must be carried out and a training programme put in place The manager must achieve an NVQ at level four in management and care (or equivalent). The registered persons must develop effective quality assurance monitoring systems. Outstanding from last inspection – timescale 30/09/06 not met. The Registered Provider must make sure that all records relating to the safekeeping of the resident’s personal money are kept up to date. Outstanding from last inspection – timescale 31/07/06 not met. The registered persons must ensure that all staff files are securely stored on the premises and available for inspection on request. The registered persons must ensure that risk assessments are completed/updated for the premises and to ensure safe working practices. A copy of the test certificate for the central heating system must be sent to the Commission. Outstanding from last inspection – timescale 31/08/07 not met. The registered persons must DS0000061674.V325252.R01.S.doc 30/04/07 16. 17. OP31 OP33 9 24 31/12/07 30/06/07 18. OP35 17(2) 31/03/07 19 OP37 17 31/03/07 20. OP38 13(4) 30/04/07 21. OP38 18 30/06/07 Page 32 Silverlea Residential Home Version 5.2 ensure that all staff receive practical moving and handling training. 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. 3. Refer to Standard OP7 OP26 Good Practice Recommendations It is recommended that the manager reviews the current care planning system and make it more user friendly. It is recommended that a washing machine with a designated sluice programme be purchased. Silverlea Residential Home DS0000061674.V325252.R01.S.doc Version 5.2 Page 33 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 Silverlea Residential Home DS0000061674.V325252.R01.S.doc Version 5.2 Page 34 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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